Organization Active NPI

Michael V. Massa, M.Ed., CCC Inc.

  • Audiologist
  • Alexandria, VA
National Provider Identifier
1861717100
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201000160 Issued in VA
Legal business name
MICHAEL V. MASSA, M.ED., CCC INC.
Practice address
6355 Walker LN Ste 411
Alexandria, VA 22310-3250
Phone
(703) 313-0373
Fax
(703) 719-0400
NPI assigned
Mar 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Authorized official

Name
Dr. Michael V Massa, AU.D.
Title
President
Phone
(703) 922-4262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X 2201000160 VA Primary

Addresses

Primary practice location

6355 Walker LN Ste 411
Alexandria, VA 22310-3250

Mailing address

6355 Walker LN Ste 411
Alexandria, VA 22310-3250
Phone (703) 922-4262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170109000198 DC Part B Supplier - Clinic/Group Practice 6002956216 Receives reassigned benefits from 5 practitioners
Practice locations: Alexandria, VA

National Provider Directory

National Provider Directory

Locations

6355 Walker Ln
Ste 411
Alexandria, VA 22310
Phone (703) 313-0373

6355 Walker Ln
Franconia, VA 22310
Phone (703) 664-7453

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287619200000",
    "number": "1861717100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 WALKER LN STE 411",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103250",
            "telephone_number": "703-922-4262",
            "fax_number": "703-719-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 WALKER LN STE 411",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103250",
            "telephone_number": "703-313-0373",
            "fax_number": "703-719-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL V. MASSA, M.ED., CCC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-30",
        "last_updated": "2010-10-21",
        "status": "A",
        "authorized_official_last_name": "MASSA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-922-4262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201000160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.