Alicia Derusso St. Thomas, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

0101281670 Issued in VA

Practice address

10521 Rosehaven St Ste Ll100
Fairfax, VA 22030-2877

Phone

(703) 281-5000

Fax

(703) 255-0765

NPI assigned

Jun 23, 2020

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

Medicare fee-for-service enrollment

Enrolled in VA, DC2 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

Specialty

Obstetrics/Gynecology

Education

Eastern Virginia Medical School, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Capital Womens Care LLCGroup PAC ID 4880582741, 281 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alicia.derussostthomas.p1@direct.cwcare.nextgenshare.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.

• Capital Women'S Care, L.L.C.

  • Obstetrics & Gynecology Physician
  • Fulton, MD
  • NPI 1679534069

  DC, VA

  Medicare reassignment Care Compare group NPD
• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061

  DC

  Medicare reassignment
• Inova Health Care Services

  • Medical Technologist
  • Sterling, VA
  • NPI 1699655589
  NPD
• Inova Health Care Services

  • Diagnostic Radiology Physician
  • Waldorf, MD
  • NPI 1851829550
  NPD

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1982220190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 MAPLE LAWN BLVD STE 235",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592694",
            "telephone_number": "301-340-8339",
            "fax_number": "301-340-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10521 ROSEHAVEN ST STE LL100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302877",
            "telephone_number": "703-281-5000",
            "fax_number": "703-255-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. THOMAS",
        "first_name": "ALICIA",
        "middle_name": "DERUSSO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101281670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manasa M Sridhar, D.O.
• Erin Killiany St Louis
• Stephen Christopher St Louis, DDS, FAGD
• Stephanie St Peter
• Kyle Andre St. Peter, LAT, ATC
• Michaela Marie Stacy
• Arielle Polifko Stafford, MD
• Jessica Erin Stafford, CPNP
• Chelsea Carolyn Stahl, DNP. FNP-C
• Neil I Stahl, MD

• Obstetrics & Gynecology Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Obstetrics & Gynecology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.