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

Mary C Tisch, PA

Individual provider Physician Assistant · NPI 1558566455

Mary C Tisch, PA is a Physician Assistant in Fairfax, Virginia. Qualified in 2007, 19 years ago. Works from 2 locations and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
19
Licensed in
VA
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3580 Joseph Siewick Dr Ste 305
Fairfax, VA 22033-1764
Phone: (703) 648-3266
Fax: (703) 648-3264
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Additional practice locations (1)

  • 2901 Telestar Ct., Falls Church, VA 22042-1262 — (703) 573-3494

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110003594 (VA)

Record details

NPI number1558566455
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 19, 2007
Last updated in NPPESAugust 27, 2021
Certification dateAugust 27, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fairfax