Individual provider Active NPI

Paola Andrea Vasquez, DPT

  • Physical Therapist
  • Fairfax, VA
National Provider Identifier
1710345525
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305210030 Issued in VA
Practice address
3620 Joseph Siewick Dr
Fairfax, VA 22033-1756
Phone
(703) 391-2450
Fax
(703) 391-3142
NPI assigned
Feb 8, 2016
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305210030 VA Primary

Addresses

Primary practice location

3620 Joseph Siewick Dr
Fairfax, VA 22033-1756

Mailing address

3620 Joseph Siewick Dr
Fairfax, VA 22033-1756
Phone (703) 391-2450

Other names 1

  • Paola Andrea Garcia Veizaga Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230811000171 DC Practitioner - Physical Therapist in Private Practice 2365804119 Reassigns benefits to 1 organization
I20230824001289 VA Practitioner - Physical Therapist in Private Practice 2365804119 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305210030VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Jun 17, 2023 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Jun 17, 2023 Accepting new patients
Inova Health Care Services Past Accepting new patients

Locations

10286 Brook Rd
Glen Allen, VA 23059
Phone (571) 200-6617

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1710345525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 JOSEPH SIEWICK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331756",
            "telephone_number": "703-391-2450",
            "fax_number": "703-391-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 JOSEPH SIEWICK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331756",
            "telephone_number": "703-391-2450",
            "fax_number": "703-391-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "PAOLA",
        "middle_name": "ANDREA",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305210030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAOLA",
            "last_name": "GARCIA VEIZAGA",
            "middle_name": "ANDREA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.