MIRIAM JACQUELINE NICOLASA CUSICANQUI MONRROY (NPI# 1497945174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497945174 |
| Entity Type | Individual |
| Full Name | MIRIAM JACQUELINE NICOLASA CUSICANQUI MONRROY |
| Other Name | BALLSTON FAMILY MEDICINE |
| Credential | MD |
| Practice Address |
1715 N George Mason Dr Suite 501 Arlington VA 22205-3609 |
| Mailing Address |
4710 Old Dominion Dr Arlington VA 22207-3527 |
| Practice Telephone | 7035274466 |
| Practice Fax Number | 7035521326 |
| Mailing Telephone | 7035274466 |
| Mailing Fax Number | 7035521326 |
| Enumeration Date | 2007-07-28 |
| Last Update Date | 2016-08-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 0101241806 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1497945174 | 05 | |
| KY | 7100033620 | 05 | |
| VA | MEDICARE PTAN | 132601 | 01 |
| Street Address |
1715 N GEORGE MASON DR SUITE 501 |
| City | ARLINGTON |
| State | VA |
| Zip Code | 22205-3609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437153111 | Deepali Kothary | Obstetrics & Gynecology | 1715 N George Mason Dr, Ste 406, Arlington, VA 22205-3662 | 2005-06-09 |
| 1578179891 | Kirsten Campbell | Physical Therapist | 1715 N George Mason Dr, Arlington, VA 22205-3609 | 2020-09-22 |
| 1346897949 | Patrick Choate | Physical Therapist | 1715 N George Mason Dr, Arlington, VA 22205-3609 | 2019-08-20 |
| 1497291769 | Thomas Stormer | Physical Therapist | 1715 N George Mason Dr, Suite 503, Medical Offices C, Arlington, VA 22205-3609 | 2017-01-11 |
| 1962850685 | Maureen Bradley | Specialist | 1715 N George Mason Dr, Suite 503, Arlington, VA 22205-3609 | 2016-06-03 |
| 1952758591 | Dianne W Robbins | Specialist | 1715 N George Mason Dr, Suite 503, Arlington, VA 22205-3609 | 2016-05-24 |
| 1891142543 | Kelly Mcgraw | Specialist | 1715 N George Mason Dr, Suite 503, Arlington, VA 22205-3609 | 2016-05-23 |
| 1518314509 | Sharon Lynn Goldman | Specialist | 1715 N George Mason Dr, Suite 504, Arlington, VA 22205-3609 | 2016-05-19 |
| 1013394725 | Allergy Partners, Pa | Allergy & Immunology | 1715 N George Mason Dr, Suite 307, Arlington, VA 22205-3609 | 2015-05-01 |
| 1528475118 | Virginia Hospital Center Physician Group LLC | Internal Medicine | 1715 N George Mason Dr, Suite 409, Arlington, VA 22205-3609 | 2014-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417315722 | Ruth Jannet Figueroa Lopez | Dentist | Blvd Cucapah 19961-9, Ampliacion Loma Bonita, Tijuana, BAJA CALIFORNIA 22205 | 2016-02-01 |
| 1083004394 | Ashley Pullum | Behavioral Analyst | 874 N Nottingham St, Arlington, VA 22205 | 2015-01-26 |
| 1548601529 | Whitney C Pelton | Physical Therapist | 5910 Wilson Blvd, Sunrise Bluemont, Arlington, VA 22205 | 2013-07-08 |
| 1134490311 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 1625 N George Mason Drive Suite 345, Arlington, VA 22205 | 2012-01-20 |
| 1518269638 | Arle Zelma Samuels | Pharmacist | 5105 W1ilson Blvd, Arlington, VA 22205 | 2010-11-22 |
| 1255640686 | Geatenet G Wasia | Pharmacist | 4851 N Washington Blvd, Arlington, VA 22205 | 2010-10-04 |
| 1518272327 | Alexis S Speight | Counselor | 1725 North George Mason Dr., Arlington, VA 22205 | 2010-08-17 |
| 1821224437 | Myriam Ferzli | Obstetrics & Gynecology | 1635 N George Mason Dr Ste 190, Arlington, VA 22205 | 2009-06-09 |
| 1427232685 | United Rehab Inc. | Home Health | 1661 N. Longfellow Street, Arlington, VA 22205 | 2007-12-24 |
| 1144426404 | Teri E Minehart | Nurse Practitioner | 1701 No. George Mason Drive, Arlington, VA 22205 | 2007-06-25 |
| Find all providers in zip 22205 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326683467 | Amy Haddad | Family Medicine | 2500 Hunter Hill Dr, Arlington, TX 76012-5519 | 2019-11-13 |
| 1689227233 | Casper Regenerative and Physical Medicine, Pllc | Family Medicine | 701 Highlander Blvd Ste 150, Arlington, TX 76015-4602 | 2019-07-23 |
| 1609432764 | Ifeanyi Duruewuru | Family Medicine | 3132 Matlock Rd Ste 311, Arlington, TX 76015-2922 | 2019-05-14 |
| 1366911034 | Quynhanh Thi Vo | Family Medicine | 501 Rita Ln Ste 109, Arlington, TX 76014-2010 | 2018-11-25 |
| 1003394396 | Mariana Stone | Family Medicine | 52a Montague St, Arlington, MA 02474-2508 | 2018-07-30 |
| 1982108312 | Premierhealth Family Medicine Pllc | Family Medicine | 601 Omega Dr Ste 203, Arlington, TX 76014-2075 | 2018-03-21 |
| 1881106607 | Yourfamilydoc Pllc | Family Medicine | 903 Medical Centre Dr Ste A, Arlington, TX 76012-4754 | 2017-11-02 |
| 1497288518 | Billiken T Lin | Family Medicine | 6515 Virginia Sq, Arlington, TX 76017-4948 | 2017-04-05 |
| 1609314392 | Post Acute Specialists, Pa | Family Medicine | 835 E Lamar Blvd # 141, Arlington, TX 76011 | 2017-02-02 |
| 1235685793 | America Medical Diagnostics, Inc | Family Medicine | 610 Crownpoint Ln, Arlington, TX 76002-4776 | 2016-08-25 |
| Find all providers in ARLINGTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.