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KODA BRINKER PMHNP-BC
NPI 1043055502
Nurse Practitioner - Psychiatric/Mental Health in Fairfax, VA

Active since June 27, 2024PECOS EnrolledAccepts Medicare Assignment
10304 EATON PL STE 100, FAIRFAX, VA 22030(571) 463-8620 Get Directions Write a Review

NPPES record last updated: November 26, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Koda Brinker Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KODA BRINKER PMHNP-BC (NPI 1043055502) is an individual psychiatric/mental health provider in Fairfax, Virginia, licensed in Virginia (0024190559) and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1043055502
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameKODA BRINKERCredential: PMHNP-BC
Location Address10304 EATON PL STE 100Fairfax, VA 22030-2221
Mailing Address732 Daly StPhiladelphia, PA 19148-3248 · (312) 995-3630
Phone(571) 463-8620
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateJune 27, 2024
Last NPPES UpdateNovember 26, 2024
NPPES CertifiedNovember 26, 2024
✔ NPI 1043055502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in VA · 0024190559✔ Licensed in DC · NP500013147
10304 EATON PL STE 100, Fairfax, VA 22030
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1800 S Frederick Ave Ste 200Gaithersburg, MD 20877-4152 · Phone (571) 463-8620
Location 21629 K St NW Ste 300Washington, DC 20006-1631 · Phone (571) 463-8620
Location 31140 3rd St NE Ste 200Washington, DC 20002-7899 · Phone (571) 463-8620

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Koda Brinker Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4486133378
PECOS Enrollment IDI20260211000014
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22030 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CALVIN LAYNE III PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (571) 463-8620
VALERIE KAY KEEHN BCBA
Behavior Analyst
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (855) 295-3276
LIFESPEED MEDICAL, LLC
Durable Medical Equipment & Medical Supplies
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (352) 232-3540
LIBAN ABDALLA
Behavior Technician
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (813) 761-0264
ANIKA LAMBA
Behavior Technician
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (813) 461-0264
FOR THE GOOD THERAPEUTIC SERVICES INC.
Counselor (Professional)
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (571) 412-1791
ANGIE IRAHETA GRUESSING
Behavior Technician
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (813) 761-0264
SOUKAINA SOUSSI
Behavior Technician
10304 EATON PL STE 100
FAIRFAX, VA 22030
Fairfax City (818) 345-2345

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Koda Brinker's NPI number?

The NPI number for Koda Brinker is 1043055502. It was assigned to this individual provider in the NPPES registry on June 27, 2024.

Where is Koda Brinker located?

Koda Brinker practices at 10304 Eaton Pl Ste 100, Fairfax, VA 22030. The listed phone number is (571) 463-8620.

What is Koda Brinker's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Koda Brinker enrolled in Medicare?

Yes. Koda Brinker is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Koda Brinker was last updated on November 26, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.