Individual provider Active NPI

Wendy Nichole Cohen, P.A.

  • Medical Physician Assistant
  • Reston, VA
National Provider Identifier
1952553935
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110002921 Issued in VA
Practice address
12359 Sunrise Valley Dr
Suite 320
Reston, VA 20191-3462
Phone
(703) 596-4796
Fax
(703) 787-8210
NPI assigned
Oct 21, 2008
Last updated
Apr 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0110002921 VA
Medical Physician Assistant 363AM0700X 0110002921 VA Primary

Addresses

Primary practice location

12359 Sunrise Valley Dr
Suite 320
Reston, VA 20191-3462

Mailing address

12359 Sunrise Valley Dr
Suite 320
Reston, VA 20191-3462
Phone (703) 596-4796

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20081114000486 DC Practitioner - Physician Assistant 2668532060 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110002921VAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Hospital Center Physician Group LLC CurrentSince Jul 22, 2024 Accepting new patients
Virginia Hospital Center Physician Group LLC CurrentSince Jul 22, 2024 Accepting new patients

Locations

1635 N George Mason Dr
Ste 430
Arlington, VA 22205
Phone (703) 528-3600

1635 N George Mason Dr
Ste 480
Arlington, VA 22205
Phone (703) 248-0111

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1952553935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR",
            "address_2": "SUITE 320",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913462",
            "telephone_number": "703-596-4796",
            "fax_number": "703-787-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR",
            "address_2": "SUITE 320",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913462",
            "telephone_number": "703-596-4796",
            "fax_number": "703-787-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "WENDY",
        "middle_name": "NICHOLE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110002921",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110002921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.