Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelly Distasio

Individual provider Physician Assistant · NPI 1801639554

Kelly Distasio is a Physician Assistant in Arlington, Virginia. Qualified in 2025, 1 year ago. Accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
1
Licensed in
VA
In the registry since
2024

Practice location Address checks out

1701 N George Mason Dr
Arlington, VA 22205-3610
Phone: (703) 248-0111
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110011392 (VA)

Record details

NPI number1801639554
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 18, 2024
Last updated in NPPESFebruary 23, 2026
Certification dateFebruary 23, 2026
Mailing address1701 N George Mason Dr, Arlington, VA 22205-3610

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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