Individual provider Active NPI

Sohail K Mirza, M.D., M.P.H.

  • Orthopaedic Surgery of the Spine Physician
  • Fairfax, VA
National Provider Identifier
1063469393
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
14258 Issued in NH
Practice address
4250 Chain Bridge Rd
Fairfax, VA 22030-4214
Phone
(703) 828-6579
Fax
(571) 458-7336
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 79228 MA
Orthopaedic Surgery of the Spine Physician 207XS0117X 14258 NH Primary
Orthopaedic Surgery of the Spine Physician 207XS0117X 0101261117 VA
Orthopaedic Surgery of the Spine Physician 207XS0117X 79154 8002 CA
Orthopaedic Surgery of the Spine Physician 207XS0117X 34710 CO
Orthopaedic Surgery of the Spine Physician 207XS0117X MD00031150 WA

Addresses

Primary practice location

4250 Chain Bridge Rd
Fairfax, VA 22030-4214

Mailing address

4250 Chain Bridge Rd
Fairfax, VA 22030-4214
Phone (703) 828-6579

Other identifiers 2

IdentifierTypeStateIssuer
1015431MedicaidVT
30208086MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170622001236 DC Practitioner - Orthopedic Surgery 6507925682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Colorado School of Medicine, Denver, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4250 Chain Bridge Rd
Fairfax, VA 22030-4214
Phone 7038286579101

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion32
Laminectomy or laminotomy (partial removal of spine bones)16
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79154 8002CAMDOrthopaedic Surgery of the Spine Physician
34710COMDOrthopaedic Surgery of the Spine Physician
79228MAMDOrthopaedic Surgery of the Spine Physician
MD00031150WAMDOrthopaedic Surgery of the Spine Physician

Organizations & group practices 1

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

Hospital & facility affiliations 7

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1063469393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 CHAIN BRIDGE RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304214",
            "telephone_number": "703-828-6579",
            "fax_number": "571-458-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 CHAIN BRIDGE RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304214",
            "telephone_number": "703-828-6579",
            "fax_number": "571-458-7336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "SOHAIL",
        "middle_name": "K",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MA",
            "license": "79228",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NH",
            "license": "14258",
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "VA",
            "license": "0101261117",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "79154 8002",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CO",
            "license": "34710",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "WA",
            "license": "MD00031150",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015431",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30208086",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.