PHANTA JAH
NPI 1174296461
Nurse Practitioner - Primary Care in Falls Church, VA

Active since August 01, 2021PECOS EnrolledAccepts Medicare Assignment
2833 CLEAVE DR., FALLS CHURCH, VA 22042(800) 969-1104 Get Directions Write a Review

NPPES record last updated: August 1, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Phanta Jah NPPES

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

PHANTA JAH (NPI 1174296461) is an individual primary care provider in Falls Church, Virginia, licensed in Virginia (0024182355) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1174296461
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NamePHANTA JAH
Location Address2833 CLEAVE DR.Falls Church, VA 22042
Mailing Address2833 Cleave Dr.Falls Church, VA 22042-1837 · (180) 096-9110
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateAugust 1, 2021
Last NPPES UpdateAugust 1, 2022
NPPES CertifiedAugust 1, 2022
NPI 1174296461 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License Licensed in VA · 0024182355
2833 CLEAVE DR., Falls Church, VA 22042

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

Phanta Jah 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 ID1153714308
PECOS Enrollment IDI20220210001108, I20220210001521
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 22042 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.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174296461, enumerated as an "individual" on August 01, 2021.

The provider is located at 2833 CLEAVE DR. FALLS CHURCH, VA 22042 and the phone number is (800) 969-1104.

Nurse Practitioner with taxonomy code 363LP2300X and a focus in Primary Care.