Individual provider Active NPI

Paola Ximena Moncada Gonzalez

  • Internal Medicine Physician
  • Fairfax, VA
National Provider Identifier
1891497764
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101288328 Issued in VA
Practice address
9401 Route 29 Ste 400
Fairfax, VA 22031-1847
Phone
(703) 383-4836
Fax
(703) 383-4911
NPI assigned
Mar 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 0101288328 VA Primary

Addresses

Primary practice location

9401 Route 29 Ste 400
Fairfax, VA 22031-1847

Mailing address

901 Harry S Truman Dr N Ste 4217
Largo, MD 20774-5477
Phone (240) 677-0236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1891497764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 HARRY S TRUMAN DR N STE 4217",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745477",
            "telephone_number": "240-677-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 ROUTE 29 STE 400",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220311847",
            "telephone_number": "703-383-4836",
            "fax_number": "703-383-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONCADA GONZALEZ",
        "first_name": "PAOLA",
        "middle_name": "XIMENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101288328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.