Individual provider Active NPI

Jasser Thiara, M.D.

  • Obstetrics & Gynecology Physician
  • Centreville, VA
National Provider Identifier
1053562009
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0101250955 Issued in VA
Practice address
13890 Braddock Rd Ste 201
Centreville, VA 20121-2437
Phone
(203) 673-9656
Fax
(571) 526-5598
NPI assigned
Oct 8, 2008
Last updated
Jan 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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 0101250955 VA Primary

Addresses

Primary practice location

13890 Braddock Rd Ste 201
Centreville, VA 20121-2437

Mailing address

13890 Braddock Rd Ste 201
Centreville, VA 20121-2437
Phone (203) 673-9656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NTMT Group Obstetrics & Gynecology Current Accepting new patients
Prosperity Labs LLC PastSince Dec 8, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

13890 Braddock Rd
Ste 201
Centreville, VA 20121
Phone (703) 631-0331

8301 Arlington Blvd
Ste 206
Fairfax, VA 22031
Phone (570) 327-5555

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.

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1053562009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13890 BRADDOCK RD STE 201",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212437",
            "telephone_number": "203-673-9656",
            "fax_number": "571-526-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13890 BRADDOCK RD STE 201",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212437",
            "telephone_number": "203-673-9656",
            "fax_number": "571-526-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIARA",
        "first_name": "JASSER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-08",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101250955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.