| Shabnam Shukrullah, PHYSICIAN ASSISTANT | |
|
1800 Jonathan Way, Reston, VA 20190-3592 | |
| (571) 888-9339 | |
| Not Available |
| Full Name | Shabnam Shukrullah |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 2 Years |
| Location | 1800 Jonathan Way, Reston, Virginia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346081718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (Virginia) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (NU) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Potomac Urology Center, Llc | 1557329406 | 17 |
| Entity Name | Potomac Urology Center, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861588592 PECOS PAC ID: 1557329406 Enrollment ID: O20041227000203 |
| Entity Name | Gastrointestinal Specialists LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063516672 PECOS PAC ID: 5294797957 Enrollment ID: O20260205000008 |
| Mailing Address | Practice Location Address |
|---|---|
| Shabnam Shukrullah, PHYSICIAN ASSISTANT 1800 Jonathan Way, Reston, VA 20190-3592 Ph: (571) 888-9339 | Shabnam Shukrullah, PHYSICIAN ASSISTANT 1800 Jonathan Way, Reston, VA 20190-3592 Ph: (571) 888-9339 |
Priscilla Khai-linh Nguyen, Physician Assistant Medicare: Medicare Enrolled Practice Location: 1860 Town Center Dr Ste 335, Reston, VA 20190 Phone: 703-787-3322 Fax: 703-787-3380 |
Mrs. Julieanne Bonner Sugg, PAC Physician Assistant Medicare: Medicare Enrolled Practice Location: 11357 Sunset Hills Rd, Reston, VA 20190 Phone: 703-435-5858 Fax: 703-435-5877 |
Ian Jacob Henry, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1850 Town Center Pkwy, Reston, VA 20190 Phone: 703-689-9000 |
Erik A Larsen, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1850 Town Center Parkway, Suite 400, Reston, VA 20190 Phone: 703-810-5202 Fax: 703-787-9664 |
Elizabeth Hamilton Sibert, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 11930 Democracy Dr, Reston, VA 20190 Phone: 888-663-6331 Fax: 415-252-7176 |
Lindsay R Tom, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1860 Town Center Dr Ste 130, Reston, VA 20190 Phone: 703-689-2050 |
Malavika Santhosh Bhalla, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1850 Town Center Pkwy Ste 310, Reston, VA 20190 Phone: 703-570-5227 |