Individual provider Active NPI

Kelly Dewyer

  • Nurse Practitioner
  • Washington, DC
National Provider Identifier
1932579893
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP1025366 Issued in DC
Practice address
2150 Pennsylvania Ave NW
Washington, DC 20037-3201
Phone
(202) 677-6903
NPI assigned
Oct 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0024172968 VA
Nurse Practitioner 363L00000X NP1025366 DC Primary

Addresses

Primary practice location

2150 Pennsylvania Ave NW
Washington, DC 20037-3201

Mailing address

2079 Daniel Stuart SQ
Woodbridge, VA 22191-3317
Phone (703) 491-5600

Other practice location 1

2079 Daniel Stuart Sq
Woodbridge, VA 22191-3317
Phone (703) 491-5600

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
I20160322000092 VA Practitioner - Nurse Practitioner 5890092753 Reassigns benefits to 1 organization
I20230503002033 DC Practitioner - Nurse Practitioner 5890092753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Faculty Associates, IncGroup PAC ID 4082528898, 676 clinicians

Practice addresses (Care Compare)

2150 Pennsylvania Ave NW
Washington, DC 20037-3201
Phone (202) 741-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024172968VAMDSpecialist
NP1025366DCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Virginia Hematology Oncology Associates PC CurrentSince Jan 24, 2016 Accepting new patients
Medical Faculty Associates, Inc CurrentSince Dec 15, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2150 Pennsylvania Ave NW
Washington, DC 20037
Phone (202) 741-2222

2150 Pennsylvania Ave NW
Fl 1
Washington, DC 20037
Phone (202) 741-2210

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

2079 Daniel Stuart Sq
Woodbridge, VA 22191
Phone (703) 491-5600

Interoperability endpoints

  • Direct secure messaging: kdewyer38568@gwmfa.direct-ci.com

Organizations & group practices 3

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": "1443830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1932579893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2079 DANIEL STUART SQ",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913317",
            "telephone_number": "703-491-5600",
            "fax_number": "703-491-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 PENNSYLVANIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200373201",
            "telephone_number": "202-677-6903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2079 Daniel Stuart Sq",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221913317",
            "country_code": "US",
            "telephone_number": "703-491-5600",
            "fax_number": "703-491-1744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEWYER",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-03",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0024172968",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DC",
            "license": "NP1025366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.