BRANDON EDWARD POLASKO (NPI# 1144669540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144669540 |
| Entity Type | Individual |
| Full Name | BRANDON EDWARD POLASKO |
| Credential | PA-C |
| Practice Address |
10100 Fairfax Blvd Fairfax VA 22030-2000 |
| Mailing Address |
5000 Cox Rd Glen Allen VA 23060-9263 |
| Practice Telephone | 7036791876 |
| Mailing Telephone | 8049685700 |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2018-04-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0110005066 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | DEA | MP2783531 | 01 |
| Street Address |
10100 FAIRFAX BLVD |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-2000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316981103 | Abdulwahab Hashem Heggi | Internal Medicine | 10100 Fairfax Blvd, Fairfax, VA 22030-2000 | 2006-06-15 |
| 1275084568 | Mariam Ali | Physician Assistant | 10100 Fairfax Blvd, Fairfax, VA 22030-2000 | 2016-10-20 |
| 1588018881 | Patient First Richmond Medical Group Pllc | Family Medicine | 10100 Fairfax Blvd, Fairfax, VA 22030-2000 | 2016-04-22 |
| 1134583008 | Patient First Richmond Medical Group | Non-Pharmacy Dispensing Site | 10100 Fairfax Blvd, Fairfax, VA 22030-2000 | 2016-04-07 |
| 1134527211 | Bridget A Baidoo | Physician Assistant | 10100 Fairfax Blvd, Fairfax, VA 22030-2000 | 2014-12-05 |
| 1164862868 | Nino Gelenidze | Family Medicine | 10100 Fairfax Blvd, Fairfax, VA 22030-2000 | 2013-06-27 |
| 1487900056 | Sheeba Mahnaz | Family Medicine | 10100 Fairfax Blvd, Fairfax, VA 22030-2000 | 2012-07-31 |
| 1073822482 | Nicol Lynn Schwandt | Physician Assistant | 10100 Fairfax Blvd, Fairfax, VA 22030 | 2010-10-03 |
| 1073845806 | Minh Khai Tran | Family Medicine | 10100 Fairfax Blvd, Fairfax, VA 22030-2000 | 2010-02-04 |
| 1760621205 | Paul Gardner Scanlan | Internal Medicine | 10100 Fairfax Blvd, Fairfax, VA 22030-2000 | 2009-02-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053894493 | Natasha Olliver | Physician Assistant | 8500 Executive Park Ave Ste 200, Fairfax, VA 22031-2228 | 2018-09-12 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1831692375 | Lauren Mackenzie Mason | Physician Assistant | 3959 Pender Dr Ste 100, Fairfax, VA 22030-6041 | 2018-03-12 |
| 1164949665 | Kaitlyn Burns | Physician Assistant | 3700 Joseph Siewick Dr Ste 404, Fairfax, VA 22033-1745 | 2017-08-25 |
| 1699299628 | Mona Yazdani | Physician Assistant | 2920 District Ave Apt 359, Fairfax, VA 22031-4466 | 2017-08-01 |
| 1518396951 | Samantha Hancock | Physician Assistant | 10721 Main St Ste 200, Fairfax, VA 22030-6913 | 2013-11-06 |
| 1114263613 | Shoshana D Katz | Physician Assistant | 3031 Javier Rd Ste 210, Fairfax, VA 22031-4638 | 2013-01-02 |
| 1770610289 | Sonia J Mabout | Physician Assistant | 2812 Old Lee Hwy # 100b-d, Fairfax, VA 22031-4315 | 2007-02-28 |
| 1396705174 | Stephanie Anne Shepard | Physician Assistant | 2700 Prosperity Ave Ste 270, Fairfax, VA 22031-4321 | 2006-03-24 |
| Find all providers in FAIRFAX | ||||
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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.