Individual provider Active NPI

Hanna L Kim, PA

  • Physician Assistant
  • Fairfax, VA
National Provider Identifier
1770852386
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110003752 Issued in VA
Practice address
3028 Javier Rd Ste 500
Fairfax, VA 22031-4622
Phone
(703) 698-8960
NPI assigned
Dec 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110003752 VA Primary

Addresses

Primary practice location

3028 Javier Rd Ste 500
Fairfax, VA 22031-4622

Mailing address

3700 Joseph Siewick Dr
Suite 308
Fairfax, VA 22033-1744
Phone (703) 698-8960

Other practice location 1

100 Elden St Ste 10
Herndon, VA 20170-4833
Phone (703) 698-8960

Other practice location 2

3914 Centreville Rd Ste 350
Chantilly, VA 20151-3289
Phone (703) 716-8700

Other practice location 3

3700 Joseph Siewick Dr
Suite 308
Fairfax, VA 22033-1744
Phone (703) 698-8960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120229000915 VA Practitioner - Physician Assistant 3375701824 Reassigns benefits to 2 organizations
I20140305001098 DC Practitioner - Physician Assistant 3375701824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

2501 Parkers LN
Alexandria, VA 22306-3209
Phone (877) 511-4625

3300 Gallows Rd
Falls Church, VA 22042-3307

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

4320 Seminary Rd
Alexandria, VA 22304-1535

44045 Rivderside Pkwy
Leesburg, VA 20176-5101

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110003752VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jul 28, 2022 Accepting new patients
Inova Health Care Services CurrentSince Jul 28, 2022 Accepting new patients
Old Dominion Anesthesia LLC Past Accepting new patients

Locations

3700 Joseph Siewick Dr
Ste 308
Fairfax, VA 22033
Phone (703) 716-8700

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Interoperability endpoints

  • Direct secure messaging: hkim63997@soc.inova.org

Organizations & group practices 5

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1770852386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR",
            "address_2": "SUITE 308",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331744",
            "telephone_number": "703-698-8960",
            "fax_number": "703-641-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3028 JAVIER RD STE 500",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314622",
            "telephone_number": "703-698-8960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Elden St Ste 10",
            "address_purpose": "LOCATION",
            "city": "Herndon",
            "state": "VA",
            "postal_code": "201704833",
            "country_code": "US",
            "telephone_number": "703-698-8960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3914 Centreville Rd Ste 350",
            "address_purpose": "LOCATION",
            "city": "Chantilly",
            "state": "VA",
            "postal_code": "201513289",
            "country_code": "US",
            "telephone_number": "703-716-8700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3700 Joseph Siewick Dr",
            "address_2": "Suite 308",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220331744",
            "country_code": "US",
            "telephone_number": "703-698-8960",
            "fax_number": "703-641-8427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "HANNA",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-28",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.