Antonietta E Vaillancourt, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

C06707 Issued in MD

Practice address

9561 White Pillar Ter
Gaithersburg, MD 20882-2816

Phone

(301) 641-8354

Fax

(301) 641-8354

NPI assigned

Dec 26, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Antonietta E Iosue Former name

Medicare fee-for-service enrollment

Enrolled in MD, 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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstar Urgent Care LLCGroup PAC ID 9335303155, 300 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: antonietta.iosue@hawaiihie.medicity.net

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.

• Medstar Urgent Care LLC

  • Urgent Care Clinic/Center
  • Baltimore, MD
  • NPI 1902175870
  Medicare reassignment Care Compare group NPD
• Medstar Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Wheaton, MD
  • NPI 1871843409

  DC

  Medicare reassignment
• Medstar Urgent Care LLC

  • General Practice Physician
  • Lexington Park, MD
  • NPI 1275410474
  NPD
• Medstar Urgent Care LLC

  • Urgent Care Clinic/Center
  • Baltimore, MD
  • NPI 1942623319
  NPD

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1811403033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23600 ROLLING FORK WAY",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208822808",
            "telephone_number": "301-641-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9561 WHITE PILLAR TER",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208822816",
            "telephone_number": "301-641-8354",
            "fax_number": "301-641-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAILLANCOURT",
        "first_name": "ANTONIETTA",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-26",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C06707",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "HI",
            "license": "AMD-789",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTONIETTA",
            "last_name": "IOSUE",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Beverly Uwanaka, OT
• Obiageli Nancy Uwazie, PHARM.D
• Jeannette Uwineza-McCoy
• Uzima Child & Family Therapy LLC
• Rajeshkumar Vaghasia, PHARMD
• Debby Vajda, LCSW-C
• Sydney Elizabeth Vallejos
• Sydney Valley
• Kelsey Van Dyke, LCSW-C
• Jennifer Van Meter, LGPC

• Surgical Physician Assistant in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Surgical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.