Mediwounds International Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MEDIWOUNDS INTERNATIONAL INC

Practice address

10701 Main St
Fairfax, VA 22030-6904

Phone

(703) 855-1771

NPI assigned

Feb 27, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Tayseer Aldaghlas, MDNPI 1427334747

Title

Ceo

Phone

(703) 855-1771

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Enrollment records 2

Locations

Practitioners 4

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

• Tayseer Aldaghlas, M.D.

  • Family Medicine Physician
  • Fairfax, VA
  • NPI 1427334747

  DC

  Medicare reassignment Care Compare group NPD Authorized official
• Renee Danielle Poesnecker, FNP

  • Family Nurse Practitioner
  • Fairfax, VA
  • NPI 1104660448

  DC

  Medicare reassignment Care Compare group NPD
• Andrew Wilmot, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Alexandria, VA
  • NPI 1063381895

  DC

  Medicare reassignment NPD
• Mustafa Rikabi, MD

  • Hospitalist Physician
  • Naples, FL
  • NPI 1588077697
  NPD (past)

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582761600000",
    "number": "1164056271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2776 S ARLINGTON MILL DR UNIT 505",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222063402",
            "telephone_number": "703-855-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 MAIN ST",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306904",
            "telephone_number": "703-855-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIWOUNDS INTERNATIONAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A",
        "authorized_official_last_name": "ALDAGHLAS",
        "authorized_official_first_name": "TAYSEER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-855-1771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; 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.