NPIMap

Individual provider Active NPI

Maryam Soumai, M.D.

  • Internal Medicine Physician
  • Fairfax, VA
National Provider Identifier
1194751586
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101240765 Issued in VA
Practice address
4211 Fairfax Corner East Ave
Suite 230
Fairfax, VA 22030-8622
Phone
(703) 802-6700
Fax
(703) 802-6701
NPI assigned
Jun 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101240765 VA Primary

Addresses

Primary practice location

4211 Fairfax Corner East Ave
Suite 230
Fairfax, VA 22030-8622

Mailing address

11728 Fairfax Woods Way
Apt 1204
Fairfax, VA 22030-8359
Phone (202) 361-5493

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services Past Accepting new patients
Clifton Burke LLC Internal Medicine PastSince Aug 6, 2009 Accepting new patients
Umc Holdings, Inc Past Accepting new patients
Ignaz P Jarbadan MD PC Internal Medicine PastSince Nov 17, 2009 Accepting new patients
Department of Medicine Faculty Practice Internal Medicine Past Accepting new patients
Atlantic Professional Services of Rhode Island Incorporated Past Accepting new patients

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194751586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11728 FAIRFAX WOODS WAY",
            "address_2": "APT 1204",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220308359",
            "telephone_number": "202-361-5493",
            "fax_number": "707-802-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 FAIRFAX CORNER EAST AVE",
            "address_2": "SUITE 230",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220308622",
            "telephone_number": "703-802-6700",
            "fax_number": "703-802-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUMAI",
        "first_name": "MARYAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101240765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.