NPIMap

Individual provider Active NPI

Nizar Mohamed Hussain, MD

  • Internal Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1023008976
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101225617 Issued in VA
Practice address
2000 Opitz Blvd
Woodbridge, VA 22191-3306
Phone
(703) 494-4116
Fax
(703) 497-0051
NPI assigned
Oct 24, 2005
Last updated
Oct 3, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101225617 VA Primary

Addresses

Primary practice location

2000 Opitz Blvd
Woodbridge, VA 22191-3306

Mailing address

2000 Opitz Blvd
Woodbridge, VA 22191-3306
Phone (703) 499-9144

Other identifiers 1

IdentifierTypeStateIssuer
0102215188MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050609000361 VA Practitioner - Internal Medicine 3779526850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2000 Opitz Blvd
Woodbridge, VA 22191-3306
Phone (703) 494-4116

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101225617VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Woodbridge Primary Care PLLC Internal Medicine CurrentSince May 15, 2015 Accepting new patients
Ridgeview Internal Medicine Internal Medicine CurrentSince Apr 26, 2016 Accepting new patients
Dominion Medical Center, LLC Internal Medicine Past Accepting new patients
Cardio Vascular Center, LLC Internal Medicine Past Accepting new patients
Hospital Physician Services, LLLP Internal Medicine Past Accepting new patients

Locations

21351 Gentry Dr
Ste 125
Sterling, VA 20166
Phone (703) 406-8686

2000 Opitz Blvd
Woodbridge, VA 22191
Phone (703) 494-4116

Interoperability endpoints

  • Direct secure messaging: nizar.hussain@1044706668969988.direct.elationemr.com

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1023008976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 OPITZ BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913306",
            "telephone_number": "703-499-9144",
            "fax_number": "703-497-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OPITZ BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913306",
            "telephone_number": "703-494-4116",
            "fax_number": "703-497-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "NIZAR",
        "middle_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101225617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102215188",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.