Individual provider Active NPI

Kenneth Michael Ahdoot, MD

  • Obstetrics & Gynecology Physician
  • Alexandria, VA
National Provider Identifier
1013017524
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0101234293 Issued in VA
Practice address
4660 Kenmore Ave
Suite #902
Alexandria, VA 22304-1313
Phone
(703) 370-4300
Fax
(703) 370-0044
NPI assigned
Sep 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Obstetrics & Gynecology Physician 207V00000X 0101234293 VA Primary

Addresses

Primary practice location

4660 Kenmore Ave
Suite #902
Alexandria, VA 22304-1313

Mailing address

4660 Kenmore Ave
Suite #902
Alexandria, VA 22304-1313
Phone (703) 370-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040226001238 DC Practitioner - Obstetrics/Gynecology 3072409838 Reassigns benefits to 2 organizations
I20210204001368 VA Practitioner - Obstetrics/Gynecology 3072409838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Physicians Edge LLCGroup PAC ID 5890913503, 73 clinicians

Practice addresses (Care Compare)

12508 Lake Ridge Dr
Lake Ridge, VA 22192-2354
Phone (703) 370-4300

2616 Sherwood Hall LN
Suite 208
Alexandria, VA 22306-3154
Phone (703) 780-6900

4660 Kenmore Ave
Suite 902
Alexandria, VA 22304-1306
Phone (703) 370-4300

5901 Kingstowne Village Pkwy
Suite 200
Alexandria, VA 22315-5882
Phone (703) 922-3434

Merit-based Incentive Payment System (MIPS)

Final score
84.06 of 100Reported as group
Quality
82.04
Improvement activities
40
Cost
70.83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101234293VAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Physician and Midwife Collaborative Practice Obstetrics & Gynecology CurrentSince Aug 1, 2003 Accepting new patients
The Physician and Midwife Collaborative Practice Obstetrics & Gynecology Past Accepting new patients
Rwjbh Primary Care Services Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2616 Sherwood Hall Ln
Ste 208
Alexandria, VA 22306
Phone (703) 780-6900

4660 Kenmore Ave
Ste 902
Alexandria, VA 22304
Phone (703) 370-4300

5901 Kingstowne Village Pkwy
Ste 200
Alexandria, VA 22315
Phone (703) 370-4300

3803 Fairfax Dr
Ste 500
Arlington, VA 22203
Phone (703) 370-4300

12508 Lake Ridge Dr
Woodbridge, VA 22192
Phone (703) 370-4300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7917/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kenneth.ahdoot.1@7917.direct.athenahealth.com

Organizations & group practices 6

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": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013017524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "address_2": "SUITE #902",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041313",
            "telephone_number": "703-370-4300",
            "fax_number": "703-370-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "address_2": "SUITE #902",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041313",
            "telephone_number": "703-370-4300",
            "fax_number": "703-370-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHDOOT",
        "first_name": "KENNETH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101234293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.