Isabella Michelle Lavista, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110010548 Issued in VA

Practice address

6355 Walker Lane, Suite 308
Alexandria, VA 22310-3247

Phone

(703) 313-7700

Fax

(703) 313-0178

NPI assigned

Jul 27, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

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 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Loudoun Medical Group, PCGroup PAC ID 0042119661, 272 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: isabella.lavista@lmg1.eclinicaldirectplus.com

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.

• Loudoun Medical Group, PC

  • Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
  • Reston, VA
  • NPI 1407908817

  DC

  Medicare reassignment Care Compare group
• MGMC, LLC

  • General Practice Physician
  • Washington, DC
  • NPI 1891797148
  Medicare reassignment
• Loudoun Medical Group, PC

  • Vascular Surgery Physician
  • Reston, VA
  • NPI 1588376321
  NPD
• Loudoun Medical Group, PC

  • Internal Medicine Physician
  • Leesburg, VA
  • NPI 1679591440
  NPD
• MGMC LLC

  • Psychiatry Physician
  • Washington, DC
  • NPI 1316949654
  NPD

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737244800000",
    "number": "1932880366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224-D CORNWALL STREET, NW, SUITE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 WALKER LANE, SUITE 308",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103247",
            "telephone_number": "703-313-7700",
            "fax_number": "703-313-0178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Reservoir Rd NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200072113",
            "country_code": "US",
            "telephone_number": "202-400-0008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVISTA",
        "first_name": "ISABELLA",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2025-01-19",
        "certification_date": "2025-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA200001769",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30017725180001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David A Lattimore
• Megan Lau, RBT
• Lauren Gibberman DDS PLLC
• Christian Lavenia
• Robert Alan Lavine, PH.D.
• Lawrence D. Singer
• Lawrence M Kotler DDS Ms
• Amber Esplin Lawrence, RDN
• Jennifer Lawrence
• Kristine Lawrence, M.S. ED

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2025; 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.