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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. ITORO IBIA M.D.
NPI 1356338206
Psychiatry & Neurology - Child & Adolescent Psychiatry in Reston, VA

Active since October 05, 2005Opted out of Medicare · through Aug 25, 2026
11701 BOWMAN GREEN DR, RESTON, VA 20190(703) 707-9777(703) 707-0690 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 13, 2026, Sep 11, 2025 (2 updates tracked since 2025).

About Dr. Itoro Ibia M.d. NPPES

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

DR. ITORO IBIA M.D. (NPI 1356338206) is an individual child & adolescent psychiatry provider in Reston, Virginia, licensed in Virginia (0101223034) and active in the NPI registry since October 2005. She has opted out of Medicare through August 25, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1356338206
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameDR. ITORO IBIACredential: M.D.
Location Address11701 BOWMAN GREEN DRReston, VA 20190-3573
Mailing AddressPo Box 2963Reston, VA 20195-0963 · (703) 707-9777 · Fax (703) 707-0690
Phone(703) 707-9777
Fax(703) 707-0690
Sole ProprietorNo
Enumeration DateOctober 5, 2005
Last NPPES UpdateJuly 13, 20262 updates tracked since enumeration
✔ NPI 1356338206 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in VA · 0101223034
Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 0101223034 (VA)
11701 BOWMAN GREEN DR, Reston, VA 20190
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Other Identifiers 4

OtherF480-0001Care First Bcbs Id
Other2037353Cigna Id
Other466688VA · Anthem Bcbs Id
Other7267195Aetna Provider Id

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Itoro Ibia M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 25, 2018 through August 25, 2026.

Opt-Out Effective DateAugust 25, 2018
Opt-Out In Effect ThroughAugust 25, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES

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

MS. CHRISTINE ANN COOK LCSW
Social Worker (Clinical)
11701 BOWMAN GREEN DR
RESTON, VA 20190
Fairfax County (703) 434-0255

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 Itoro Ibia's NPI number?

The NPI number for Itoro Ibia is 1356338206. It was assigned to this individual provider in the NPPES registry on October 5, 2005.

Where is Itoro Ibia located?

Itoro Ibia practices at 11701 Bowman Green Dr, Reston, VA 20190. The listed phone number is (703) 707-9777.

What is Itoro Ibia's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Itoro Ibia enrolled in Medicare?

No. Itoro Ibia has opted out of Medicare through August 25, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Itoro Ibia was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.