Individual provider Active NPI

Jessica Lynn Ghareeb

  • Physician Assistant
  • Manassas, VA
National Provider Identifier
1881091874
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110004786 Issued in VA
Practice address
8100 Ashton Ave Ste 200
Manassas, VA 20109-5688
Phone
(877) 415-4116
NPI assigned
Nov 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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 0110004786 VA Primary

Addresses

Primary practice location

8100 Ashton Ave Ste 200
Manassas, VA 20109-5688

Mailing address

8100 Ashton Ave Ste 200
Manassas, VA 20109-5688
Phone (561) 312-1081

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
I20150225001611 VA Practitioner - Physician Assistant 7416273016 Reassigns benefits to 2 organizations
I20160310000645 DC Practitioner - Physician Assistant 7416273016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fauquier Physician Practices LLCGroup PAC ID 6406083104, 43 clinicians

Practice addresses (Care Compare)

500 Hospital Dr
Warrenton, VA 20186-3027
Phone (540) 316-4360

550 Hospital Dr
Warrenton, VA 20186-3027
Phone (540) 316-5940

Hospital & facility affiliations

  • Fauquier Hospital Hospital, Warrenton, VA, CCN 490023

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Feb 6, 2016 Accepting new patients
Inova Health Care Services CurrentSince Feb 6, 2016 Accepting new patients
Physical Medicine Associates, LTD Past Accepting new patients

Locations

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

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

8100 Ashton Ave
Ste 200
Manassas, VA 20109
Phone (571) 581-1771

1850 Town Center Pkwy
Ste 566
Reston, VA 20190

422 Garrisonville Rd
Ste 110
Stafford, VA 22554
Phone (540) 657-6400

415 Church St NE
Ste 101
Vienna, VA 22180
Phone (571) 432-9454

559 Frost Ave
Ste 102
Warrenton, VA 20186
Phone (540) 341-7530

14605 Potomac Branch Dr
Ste 100
Woodbridge, VA 22191
Phone (703) 738-4371

Interoperability endpoints

  • Direct secure messaging: jessica.kelly.p1@direct.chv.nextgenshare.com

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 1

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": "1416355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1881091874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 ASHTON AVE STE 200",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095688",
            "telephone_number": "561-312-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 ASHTON AVE STE 200",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095688",
            "telephone_number": "877-415-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAREEB",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-19",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.