Fella Ezzekmi-Aksouh, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110001167 Issued in VA

Practice address

201 Elden St
Ste #101
Herndon, VA 20170-4853

Phone

(703) 668-0222

Fax

(703) 668-0224

NPI assigned

Jan 11, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, VA2 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

Howard University College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.36 of 100Reported as group

Quality

73.03

Promoting interoperability

100

Improvement activities

40

Cost

71.49

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: fezzekmiaksouh249955@soc.inova.org

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.

• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061

  DC

  Medicare reassignment Care Compare group
• Walk in Medical Center P.C.

  • Medical Physician Assistant
  • Herndon, VA
  • NPI 1447540604
  NPD (past)
• Walk-in Medical Center PC

  • Family Medicine Physician
  • Falls Church, VA
  • NPI 1770887655
  NPD (past)

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1912202664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 ELDEN ST",
            "address_2": "STE #101",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704853",
            "telephone_number": "703-668-0222",
            "fax_number": "703-668-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ELDEN ST",
            "address_2": "STE #101",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704853",
            "telephone_number": "703-668-0222",
            "fax_number": "703-668-0224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8501 Sudley Rd",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201093563",
            "country_code": "US",
            "telephone_number": "571-719-4180",
            "fax_number": "571-719-4181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZZEKMI-AKSOUH",
        "first_name": "FELLA",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-11",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110001667",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fezzekmiaksouh249955@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Health Care Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "46440 Benedict Dr Ste 208",
            "city": "Sterling",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201646602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physician Assistant in Herndon, VA
• Providers in Herndon, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.