Individual provider Active NPI

Mobashar Ahmad, M.D.

  • Emergency Medicine Physician
  • Herndon, VA
National Provider Identifier
1003844911
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101049338 Issued in VA
Practice address
1110 Elden St # a
Suite 102
Herndon, VA 20170-5529
Phone
(703) 707-3707
Fax
(703) 707-9010
NPI assigned
Jun 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101049338 VA Primary

Addresses

Primary practice location

1110 Elden St # a
Suite 102
Herndon, VA 20170-5529

Mailing address

1110 Elden St # a
Suite 102
Herndon, VA 20170-5529
Phone (703) 707-3707

Other identifiers 3

IdentifierTypeStateIssuer
5966669OtherVAAETNA PPO
386123OtherVAANTHEM BC/BS
G82400001OtherVACAREFIRST BC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101049338VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Virginia Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
MCV Associated Physicians Emergency Medicine PastSince Sep 28, 2021 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003844911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 ELDEN ST # A",
            "address_2": "SUITE 102",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705529",
            "telephone_number": "703-707-3707",
            "fax_number": "703-707-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 ELDEN ST # A",
            "address_2": "SUITE 102",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705529",
            "telephone_number": "703-707-3707",
            "fax_number": "703-707-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMAD",
        "first_name": "MOBASHAR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101049338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5966669",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "386123",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC/BS",
            "identifier": "G82400001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

Verify at the official NPI Registry.