Individual provider Active NPI

Abdulrahman Alahmad, PT

  • Physical Therapist
  • Fairfax, VA
National Provider Identifier
1124458971
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305209922 Issued in VA
Practice address
4401 Fair Lakes CT # 304
Fairfax, VA 22033-3805
Phone
(917) 615-3518
NPI assigned
Nov 14, 2013
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305209922 VA Primary

Addresses

Primary practice location

4401 Fair Lakes CT # 304
Fairfax, VA 22033-3805

Mailing address

3638 Buckeye CT
Fairfax, VA 22033-1254
Phone (917) 615-3518

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241230001932 DC Practitioner - Physical Therapist in Private Practice 3072741024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4401 Fair Lakes CT
Suite 304
Fairfax, VA 22033-3805
Phone (971) 615-3518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305209922VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Project Health Corp CurrentSince Oct 13, 2024 Accepting new patients
Project Health Physical Therapy and Wellness LLC Physical Therapist CurrentSince Oct 20, 2024 Accepting new patients

Locations

4401 Fair Lakes Ct
#304
Fairfax, VA 22033
Phone (703) 899-4109

4401 Fair Lakes Ct
Ste 304
Fairfax, VA 22033
Phone (971) 615-3518

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Project Health CorpFairfax, VA, CCN 497819 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
Corporate Director (100%)
W-2 Managing Employee (100%)
Mar 30, 2020
Mar 30, 2020
Mar 30, 2020
Mar 30, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1124458971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3638 BUCKEYE CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331254",
            "telephone_number": "917-615-3518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 FAIR LAKES CT # 304",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333805",
            "telephone_number": "917-615-3518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAHMAD",
        "first_name": "ABDULRAHMAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-14",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305209922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.