Organization Active NPI

Nasrin Ejtemaee MD PC

  • Adult Medicine Physician
  • McLean, VA
National Provider Identifier
1164676409
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
NASRIN EJTEMAEE MD PC
Practice address
8375A Greensboro Dr
MC Lean, VA 22102-3529
Phone
(703) 893-8345
Fax
(703) 356-2730
NPI assigned
Nov 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Authorized official

Name
Dr. Nasrin Ejtemaee, M.D.NPI 1497850077
Title
President
Phone
(703) 893-8345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

8375A Greensboro Dr
MC Lean, VA 22102-3529

Mailing address

8375A Greensboro Dr
MC Lean, VA 22102-3529
Phone (703) 893-8345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20111115000021 VA Part B Supplier - Clinic/Group Practice 1355515032 Receives reassigned benefits from 1 practitioner
Practice locations: Ashburn, VA
O20120227000110 DC Part B Supplier - Clinic/Group Practice 1355515032 Receives reassigned benefits from 1 practitioner
Practice locations: McLean, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D0971768Nasrin Ejtemaee MD PC8375 Greensboro Drive -Suite a, McLean, VA 22102Certificate of waiverMar 20, 2028

National Provider Directory

National Provider Directory

Locations

8375A Greensboro Dr
McLean, VA 22102
Phone (703) 893-8345

8375 Greensboro Dr
#A
McLean, VA 22102
Phone (703) 893-8345

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226534400000",
    "number": "1164676409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8375A GREENSBORO DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023529",
            "telephone_number": "703-893-8345",
            "fax_number": "703-356-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8375A GREENSBORO DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023529",
            "telephone_number": "703-893-8345",
            "fax_number": "703-356-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NASRIN EJTEMAEE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-13",
        "last_updated": "2008-11-13",
        "status": "A",
        "authorized_official_last_name": "EJTEMAEE",
        "authorized_official_first_name": "NASRIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-893-8345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.