Individual provider Active NPI

Allison Koutsandreas, FNP-BC

  • Family Nurse Practitioner
  • Fairfax, VA
National Provider Identifier
1972042596
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024174490 Issued in VA
Practice address
8081 Innovation Park Dr Ste 900
Fairfax, VA 22031-4867
Phone
(571) 423-4200
Fax
(571) 472-4201
NPI assigned
Feb 15, 2017
Last updated
Sep 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016016265 MD
Family Nurse Practitioner 363LF0000X 0024174490 VA Primary

Addresses

Primary practice location

8081 Innovation Park Dr Ste 900
Fairfax, VA 22031-4867

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other identifiers 1

IdentifierTypeStateIssuer
213293228MedicaidDC

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: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170502000742 DC Practitioner - Nurse Practitioner 3971880857 Reassigns benefits to 3 organizations
I20231023001955 VA Practitioner - Nurse Practitioner 3971880857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Marymount University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, shared by 24 NPIs, 1,821 clinicians

Practice addresses (Care Compare)

3800 Fettler Park Dr
Suite 312
Dumfries, VA 22025-2043
Phone (571) 472-6791

8081 Innovation Park Dr
Suite 900
Fairfax, VA 22031-4867
Phone (571) 472-4100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016016265MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Faculty Associates, Inc CurrentSince Mar 20, 2017 Accepting new patients
Inova Health Care Services CurrentSince Jun 2, 2023 Accepting new patients
Inova Health Care Services CurrentSince Aug 12, 2023 Accepting new patients
Inova Health Care Services CurrentSince Jun 2, 2023 Accepting new patients
Inova Health Care Services CurrentSince Jan 30, 2025 Accepting new patients

Locations

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

1500 N Beauregard St
Ste 300
Alexandria, VA 22311
Phone (703) 845-1500

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

3800 Fettler Park Dr
Ste 312
Dumfries, VA 22025
Phone (571) 472-6791

3620 Joseph Siewick Dr
Ste 400
Fairfax, VA 22033
Phone (703) 264-7801

8081 Innovation Park Dr
Ste 900
Fairfax, VA 22031
Phone (571) 472-4200

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44055 Riverside Pkwy
Ste 110
Leesburg, VA 20176
Phone (703) 391-4500

Interoperability endpoints

  • Direct secure messaging: akoutsandreas1091282@soc.inova.org
  • Direct secure messaging: akoutsandreas19696@gwmfa.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1972042596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 INNOVATION PARK DR STE 900",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314867",
            "telephone_number": "571-423-4200",
            "fax_number": "571-472-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTSANDREAS",
        "first_name": "ALLISON",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "2016016265",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213293228",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.