Individual provider Active NPI

Nicole Leslie Dease, NP

  • Acute Care Nurse Practitioner
  • Washington, DC
National Provider Identifier
1972167666
Registry record updated Apr 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN1046412 Issued in DC
Practice address
3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone
(202) 444-2000
NPI assigned
Apr 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN1046412 DC Primary

Addresses

Primary practice location

3800 Reservoir Rd NW
Washington, DC 20007-2113

Mailing address

5850 Cameron Run Ter Apt 215
Alexandria, VA 22303-2715
Phone (609) 457-7120

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
I20200203000417 DC Practitioner - Nurse Practitioner 2769818228 Reassigns benefits to 1 organization
I20210601001566 VA Practitioner - Nurse Practitioner 2769818228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1046412DCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates of Northern Virginia, LLC CurrentSince Jun 1, 2021 Accepting new patients
Kesani Essentials Wellness and Aesthetics Medspa PLLC CurrentSince Dec 1, 2024 Accepting new patients
Old Dominion Anesthesia LLC Past Accepting new patients

Locations

6911 Richmond Hwy
Ste 301A
Alexandria, VA 22306
Phone (703) 215-7957

3700 Joseph Siewick Dr
Ste 308
Fairfax, VA 22033
Phone (703) 716-8700

3022 Williams Dr
Ste 301
Fairfax, VA 22031
Phone (703) 698-1775

24570 Medical Dr
Sterling, VA 20166
Phone (571) 367-4400

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.

NPI Registry JSON

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

{
    "created_epoch": "1556409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556409600000",
    "number": "1972167666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 CAMERON RUN TER APT 215",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223032715",
            "telephone_number": "609-457-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113",
            "telephone_number": "202-444-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEASE",
        "first_name": "NICOLE",
        "middle_name": "LESLIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-28",
        "last_updated": "2019-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "DC",
            "license": "RN1046412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.