Individual provider Active NPI

Amanda Paternostro

  • Obstetrics & Gynecology Physician
  • Alexandria, VA
National Provider Identifier
1962899963
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0101266406 Issued in VA
Practice address
4660 Kenmore Ave Ste 902
Alexandria, VA 22304-1306
Phone
(703) 370-4300
Fax
(703) 370-0044
NPI assigned
Apr 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 0101266406 VA Primary

Addresses

Primary practice location

4660 Kenmore Ave Ste 902
Alexandria, VA 22304-1306

Mailing address

4660 Kenmore Ave
Ste 902
Alexandria, VA 22304-1306
Phone (215) 955-1085

Other identifiers 1

IdentifierTypeStateIssuer
0101266406OtherVAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191014002899 DC Practitioner - Obstetrics/Gynecology 8224359377 Reassigns benefits to 2 organizations
I20201228000986 VA Practitioner - Obstetrics/Gynecology 8224359377 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Physicians Edge LLCGroup PAC ID 5890913503, 73 clinicians
The Physician and Midwife Collaborative PracticeGroup PAC ID 0648166405, 21 clinicians

Practice addresses (Care Compare)

12508 Lake Ridge Dr
Woodbridge, VA 22192-2354
Phone (703) 370-4300

3803 Fairfax Dr
Suite 500
Arlington, VA 22203-5861
Phone (703) 842-0602

4660 Kenmore Ave
Suite 902
Alexandria, VA 22304-1306
Phone (703) 370-4300

Hospital & facility affiliations

  • Inova Mount Vernon Hospital Hospital, Alexandria, VA, CCN 490122

Merit-based Incentive Payment System (MIPS)

Final score
84.06 of 100Reported as group
Quality
82.04
Improvement activities
40
Cost
70.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101266406VAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Physician and Midwife Collaborative Practice Obstetrics & Gynecology CurrentSince Aug 21, 2019 Accepting new patients
The Physician and Midwife Collaborative Practice Obstetrics & Gynecology Past Accepting new patients

Locations

2616 Sherwood Hall Ln
Ste 208
Alexandria, VA 22306
Phone (703) 780-6900

4660 Kenmore Ave
Ste 902
Alexandria, VA 22304
Phone (703) 370-4300

5901 Kingstowne Village Pkwy
Ste 200
Alexandria, VA 22315
Phone (703) 370-4300

3803 Fairfax Dr
Ste 500
Arlington, VA 22203
Phone (703) 842-0602

12508 Lake Ridge Dr
Woodbridge, VA 22192
Phone (703) 370-4300

Interoperability endpoints

  • Direct secure messaging: amanda.paternostro.1@7917.direct.athenahealth.com

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 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": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1962899963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "address_2": "STE 902",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041306",
            "telephone_number": "215-955-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE STE 902",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041306",
            "telephone_number": "703-370-4300",
            "fax_number": "703-370-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATERNOSTRO",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-17",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101266406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "0101266406",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.