Individual provider Active NPI

Hanna A Kifle, PA-C

  • Physician Assistant
  • Washington, DC
National Provider Identifier
1780822379
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA200001595 Issued in DC
Practice address
1350 Connecticut Ave NW Ste 1250
Washington, DC 20036-1728
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Feb 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002910 VA
Physician Assistant 363A00000X PA17391 TX
Physician Assistant 363A00000X 12095 GA
Physician Assistant 363A00000X PA200001595 DC Primary

Addresses

Primary practice location

1350 Connecticut Ave NW Ste 1250
Washington, DC 20036-1728

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

11711 Livingston Rd
Ft Washington, MD 20744-5151
Phone (301) 203-2250

Other practice location 2

6230 Rolling Rd Ste J
Springfield, VA 22152-2326
Phone (571) 889-3235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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
I20091102000173 DC Practitioner - Physician Assistant 0547307068 Reassigns benefits to 1 organization
I20110613000363 VA Practitioner - Physician Assistant 0547307068 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA200001595DCMDPhysician Assistant
PA17391TXMDPhysician Assistant
0110002910VAMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1780822379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 CONNECTICUT AVE NW STE 1250",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200361728",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11711 Livingston Rd",
            "address_purpose": "LOCATION",
            "city": "Ft Washington",
            "state": "MD",
            "postal_code": "207445151",
            "country_code": "US",
            "telephone_number": "301-203-2250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6230 Rolling Rd Ste J",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "VA",
            "postal_code": "221522326",
            "country_code": "US",
            "telephone_number": "571-889-3235",
            "fax_number": "571-889-3236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIFLE",
        "first_name": "HANNA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002910",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17391",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12095",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA200001595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.