NPIMap

Individual provider Active NPI

Mobolaji Fowose, MD

  • Emergency Medicine Physician
  • Reston, VA
National Provider Identifier
1194353847
Registry record updated Mar 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101280819 Issued in VA
Practice address
1850 Town Center Pkwy
Reston, VA 20190-3204
Phone
(703) 689-9000
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101280819 VA Primary

Addresses

Primary practice location

1850 Town Center Pkwy
Reston, VA 20190-3204

Mailing address

3400 Spruce St
Philadelphia, PA 19104-4238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, PA, TX, NC5 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20241017002357 DC Practitioner - Emergency Medicine 4587196340 Reassigns benefits to 1 organization
I20241112000092 VA Practitioner - Emergency Medicine 4587196340 Reassigns benefits to 2 organizations
I20251014003233 PA Practitioner - Emergency Medicine 4587196340 Reassigns benefits to 2 organizations
I20251031000526 TX Practitioner - Emergency Medicine 4587196340 Reassigns benefits to 2 organizations
I20260105000588 NC Practitioner - Emergency Medicine 4587196340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Saint Louis University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians

Practice addresses (Care Compare)

1602 Skipwith Rd
Richmond, VA 23229-5205
Phone (804) 289-4500

1705 Tarboro St SW
Wilson, NC 27893-3428
Phone (252) 399-8101

24440 Stone Springs Blvd
Dulles, VA 20166-2247
Phone (240) 686-2300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine Current Accepting new patients
Upmc Altoona CurrentSince Oct 15, 2025 Accepting new patients
Northeast Texas Emergency Physicians, PLLC Emergency Medicine CurrentSince Sep 1, 2025 Accepting new patients
Upmc Altoona CurrentSince Oct 15, 2025 Accepting new patients
Emergency Medicine Associates PA Emergency Medicine CurrentSince Aug 20, 2024 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Sep 5, 2025 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Aug 20, 2024 Accepting new patients
Upmc Bedford Memorial CurrentSince Oct 15, 2025 Accepting new patients
Upmc Bedford Memorial Emergency Medicine CurrentSince Oct 15, 2025 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. CurrentSince Sep 1, 2024 Accepting new patients

Locations

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

1705 Tarboro St SW
Wilson, NC 27893
Phone (252) 399-8040

620 Howard Ave
Altoona, PA 16601
Phone (814) 889-2011

10455 Lincoln Hwy
Everett, PA 15537
Phone (814) 623-3550

1007 S William St
Atlanta, TX 75551
Phone (903) 614-2000

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

1602 Skipwith Rd
Richmond, VA 23229
Phone (804) 289-4500

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

Organizations & group practices 11

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 5

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743292800000",
    "number": "1194353847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 TOWN CENTER PKWY",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903204",
            "telephone_number": "703-689-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWOSE",
        "first_name": "MOBOLAJI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2025-03-30",
        "certification_date": "2025-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101280819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.