Active Medical Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101237882 Issued in VA

Legal business name

ACTIVE MEDICAL CARE LLC

Practice address

3930 Pender Dr Ste 230
Fairfax, VA 22030-0992

Phone

(703) 620-6221

Fax

(703) 620-6628

NPI assigned

Apr 27, 2009

Organization subpart

No

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

Authorized official

Name

Khairunnisa Masood, MDNPI 1093731499

Title

Owner

Phone

(703) 987-8165

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Khairunnisa Masood, MD

  • Internal Medicine Physician
  • Fairfax, VA
  • NPI 1093731499

  DC, Specialist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1073757662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4879 MAYDE CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306618",
            "telephone_number": "703-620-6221",
            "fax_number": "703-620-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 PENDER DR STE 230",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220300992",
            "telephone_number": "703-620-6221",
            "fax_number": "703-620-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE MEDICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-27",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "MASOOD",
        "authorized_official_first_name": "KHAIRUNNISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-987-8165",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101237882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.