Individual provider Active NPI

Issam Khayata, MD

  • Pain Medicine (Anesthesiology) Physician
  • Sterling, VA
National Provider Identifier
1174576581
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
0101259392 Issued in VA
Practice address
20 Pidgeon Hill Dr
Ste 205
Sterling, VA 20165-6134
Phone
(508) 334-3271
Fax
(508) 856-5911
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101259392 VA
Anesthesiology Physician 207L00000X 212629 MA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 0101259392 VA
Pain Medicine (Anesthesiology) Physician 207LP2900X 0101259392 VA Primary

Addresses

Primary practice location

20 Pidgeon Hill Dr
Ste 205
Sterling, VA 20165-6134

Mailing address

PO Box 2521
Reston, VA 20195-0521

Other practice location 1

44055 Riverside Pkwy Ste 110
Leesburg, VA 20176-5155
Phone (703) 858-6115

Other identifiers 2

IdentifierTypeStateIssuer
0179043MedicaidMA
30015831410003MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170627000873 DC Practitioner - Pain ManagementPractitioner - AnesthesiologyPractitioner - Critical Care (Intensivists) 9133164064 Reassigns benefits to 5 organizations
I20190117002531 VA Practitioner - Pain ManagementPractitioner - AnesthesiologyPractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 9133164064 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology, Critical Care (Intensivists)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, shared by 24 NPIs, 1,821 clinicians

Practice addresses (Care Compare)

3800 Fettler Park Dr
Dumfries, VA 22025-2043
Phone (571) 472-6791

44055 Riverside Pkwy
Leesburg, VA 20176-5155

44055 Riverside Pkwy
Leesburg, VA 20176-5179
Phone (703) 858-6192

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063
  • Inova Loudoun Hospital Hospital, Leesburg, VA, CCN 490043

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
212629MAMDAnesthesiology Physician
0101259392VAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Virginia, LLC Anesthesiology CurrentSince Nov 28, 2022 Accepting new patients
Inova Health Care Services Critical Care Medicine CurrentSince Mar 18, 2024 Accepting new patients
Inova Health Care Services CurrentSince Mar 18, 2024 Accepting new patients
American Anesthesiology of Virginia PC Anesthesiology CurrentSince May 5, 2023 Accepting new patients
American Anesthesiology of Virginia, PC Anesthesiology CurrentSince May 5, 2023 Accepting new patients
Old Dominion Anesthesia LLC Anesthesiology CurrentSince Feb 11, 2024 Accepting new patients
Inova Health Care Services Critical Care Medicine CurrentSince Jun 17, 2024 Accepting new patients
Anesthesia Associates of Springfield Inc Anesthesiology Past Accepting new patients
Emerson Anesthesia Associates P C Anesthesiology Past Accepting new patients
Washington Nephrology Associates, L.L.P. Past Accepting new patients

Locations

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

1800 N Beauregard St
Ste 200
Alexandria, VA 22311
Phone (703) 823-3750

3914 Centreville Rd
Ste 350
Chantilly, VA 20151
Phone (703) 263-3393

1139 E High St
Ste 105
Charlottesvle, VA 22902
Phone (434) 817-8484

3800 Fettler Park Dr
Ste 312
Dumfries, VA 22025
Phone (571) 472-6791

8081 Innovation Park Dr
Ste 900
Fairfax, VA 22031
Phone (571) 472-4200

8505 Arlington Blvd
Ste 400
Fairfax, VA 22031
Phone (571) 226-5600

3620 Joseph Siewick Dr
Ste 202
Fairfax, VA 22033
Phone (703) 766-6960

3028 Javier Rd
Ste 400
Fairfax, VA 22031
Phone (703) 716-1097

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

44055 Riverside Pkwy
Ste 110
Leesburg, VA 20176
Phone (703) 391-4500

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44055 Riverside Pkwy
Ste 118
Leesburg, VA 20176
Phone (571) 472-4600

44055 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 724-7530

24440 Stone Springs Blvd
Sterling, VA 20166
Phone (571) 206-8696

Interoperability endpoints

  • Direct secure messaging: ikhayata1287080@soc.inova.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1174576581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2521",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201950521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PIDGEON HILL DR",
            "address_2": "STE 205",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656134",
            "telephone_number": "508-334-3271",
            "fax_number": "508-856-5911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44055 Riverside Pkwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201765155",
            "country_code": "US",
            "telephone_number": "703-858-6115",
            "fax_number": "571-665-6634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAYATA",
        "first_name": "ISSAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101259392",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "212629",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VA",
            "license": "0101259392",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "VA",
            "license": "0101259392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0179043",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30015831410003",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

Verify at the official NPI Registry.