Individual provider Active NPI

Dorine Ndayizigiye

  • Clinical Social Worker
  • Fairfax, VA
National Provider Identifier
1790323467
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
10615 Judicial Dr Ste 301
Fairfax, VA 22030-7501
Phone
(540) 908-1765
NPI assigned
Dec 12, 2019
Last updated
Dec 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

10615 Judicial Dr Ste 301
Fairfax, VA 22030-7501

Mailing address

10615 Judicial Dr Ste 301
Fairfax, VA 22030-7501
Phone (540) 908-1765

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL http://www.novaolderadultcounseling.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, PA, LA, CT, WI5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20200129001918 DC Practitioner - Clinical Social Worker 1658707336 Reassigns benefits to 1 organization
I20260603002352 PA Practitioner - Clinical Social Worker 1658707336 Reassigns benefits to 1 organization
I20260603003113 LA Practitioner - Clinical Social Worker 1658707336 Reassigns benefits to 1 organization
I20260606000319 CT Practitioner - Clinical Social Worker 1658707336 Reassigns benefits to 1 organization
I20260611003094 WI Practitioner - Clinical Social Worker 1658707336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, 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": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1790323467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10615 JUDICIAL DR STE 301",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307501",
            "telephone_number": "540-908-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10615 JUDICIAL DR STE 301",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307501",
            "telephone_number": "540-908-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDAYIZIGIYE",
        "first_name": "DORINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.novaolderadultcounseling.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3306 Wyndham Cir Apt 230",
            "city": "Alexandria",
            "state": "VA",
            "country_code": "US",
            "postal_code": "223024306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.