Organization Active NPI

Siesta Health Services PC

  • Sleep Medicine (Family Medicine) Physician
  • Dumfries, VA
National Provider Identifier
1194510115
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Family Medicine) PhysicianTaxonomy code 207QS1201X
Legal business name
SIESTA HEALTH SERVICES PC
Practice address
3763 Fettler Park Dr
Dumfries, VA 22025-1946
Phone
(866) 938-9996
NPI assigned
Apr 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Authorized official

Name
Mashkour Rab
Title
Office Manager
Phone
(832) 969-3844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS1201X Primary

Addresses

Primary practice location

3763 Fettler Park Dr
Dumfries, VA 22025-1946

Mailing address

13036 Brierly Forest CT
Manassas, VA 20112-8869
Phone (866) 938-9996

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250618000035 VA Part B Supplier - Clinic/Group Practice 3870004690 Receives reassigned benefits from 1 practitioner
Practice locations: Dumfries, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1744243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1194510115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13036 BRIERLY FOREST CT",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201128869",
            "telephone_number": "866-938-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3763 FETTLER PARK DR",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220251946",
            "telephone_number": "866-938-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIESTA HEALTH SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-10",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A",
        "authorized_official_last_name": "RAB",
        "authorized_official_first_name": "MASHKOUR",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "832-969-3844"
    },
    "taxonomies": [
        {
            "code": "207QS1201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dumfries, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.