Individual provider Active NPI

Abucar Adan Abdulle, INTERNAL MEDICINE MD

  • Internal Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1073659900
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101046722 Issued in VA
Practice address
12761 Darby Brook CT
Ste 101
Woodbridge, VA 22192-2405
Phone
(703) 730-5064
Fax
(571) 408-4308
NPI assigned
Jan 29, 2007
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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 0101046722 VA Primary

Addresses

Primary practice location

12761 Darby Brook CT
Ste 101
Woodbridge, VA 22192-2405

Mailing address

12761 Darby Brook CT
Ste 101
Woodbridge, VA 22192-2405
Phone (703) 730-5064

Other identifiers 1

IdentifierTypeStateIssuer
005844266MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20120427000003 VA Practitioner - Internal Medicine 5698937209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12761 Darby Brook CT
Suite 101
Woodbridge, VA 22192-2405
Phone (703) 730-5064

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101046722VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Internal Medicine CurrentSince Nov 3, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 3, 2016 Accepting new patients
Abucar a. Abdulle, MD. PC Internal Medicine CurrentSince Jun 18, 1997 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2215 Landover Pl
Lynchburg, VA 24501
Phone (434) 947-3900

8644 Sudley Rd
#220
Manassas, VA 20110

12761 Darby Brook Ct
Ste 101
Woodbridge, VA 22192
Phone (703) 490-5090

Organizations & group practices 4

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 1

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1073659900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12761 DARBY BROOK CT",
            "address_2": "STE 101",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922405",
            "telephone_number": "703-730-5064",
            "fax_number": "571-408-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12761 DARBY BROOK CT",
            "address_2": "STE 101",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922405",
            "telephone_number": "703-730-5064",
            "fax_number": "571-408-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDULLE",
        "first_name": "ABUCAR",
        "middle_name": "ADAN",
        "credential": "INTERNAL MEDICINE MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101046722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005844266",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.