Individual provider Active NPI

Colleen Burkhart, PA-C

  • Physician Assistant
  • Reston, VA
National Provider Identifier
1982335444
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110007630 Issued in VA
Practice address
1886 Metro Center Dr Ste 650
Reston, VA 20190-5294
Phone
(703) 437-7744
Fax
(703) 435-3951
NPI assigned
Jun 23, 2022
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110007630 VA Primary
Medical Physician Assistant 363AM0700X NU

Addresses

Primary practice location

1886 Metro Center Dr Ste 650
Reston, VA 20190-5294

Mailing address

4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450
Phone (561) 948-0291

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
I20230310001077 DC Practitioner - Physician Assistant 9931572088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Dermatology of Reston LLCGroup PAC ID 4981971256, 5 clinicians

Practice addresses (Care Compare)

1886 Metro Ctr Dr
Suite 650
Reston, VA 20190-5294
Phone (703) 437-7744

National Provider Directory

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

Organizations & group practices 1

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": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1982335444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-948-0291",
            "fax_number": "561-859-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1886 METRO CENTER DR STE 650",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905294",
            "telephone_number": "703-437-7744",
            "fax_number": "703-435-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHART",
        "first_name": "COLLEEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110007630",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.