Active NPI
Ian H Leibowitz, M.D.
- Pediatric Gastroenterology Physician
- Washington, DC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- MDO46686
- Practice address
- 111 Michigan Ave NW
Washington, DC 20010 - Phone
- (202) 476-5000
- NPI assigned
- Feb 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Gastroenterology Physician | 2080P0206X | 0101036573 | VA | |
| Pediatric Gastroenterology Physician | 2080P0206X | MDO46686 | DC | Primary |
Addresses
Primary practice location
111 Michigan Ave NW
Washington, DC 20010
Mailing address
PO Box 744785
Atlanta, GA 30374-4785
Phone (202) 476-5000
Other practice location 1
3022 Williams Dr
Suite 301
Fairfax, VA 22031-4600
Phone (703) 698-8960 ext. 238
Other practice location 2
3023 Hamaker Ct Fl 6
Fairfax, VA 22031-2207
Phone (703) 876-2788
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6071787 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MDO46686 | DC | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital | Current | Accepting new patients | |
| Children'S Hospital | Current | Accepting new patients | |
| Children'S Hospital | Current | Accepting new patients | |
| Old Dominion Anesthesia LLC | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Gastroenterology Associates of Northern Virginia, LLC | Pediatric Gastroenterology | Past | Accepting new patients |
Locations
111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670
3023 Hamaker Ct
Ste 400
Fairfax, VA 22031
Phone (571) 226-8380
3022 Williams Dr
Ste 301
Fairfax, VA 22031
Phone (703) 698-1775
3023 Hamaker Ct
Fl 6
Fairfax, VA 22031
Interoperability endpoints
- ileibowitz5593@soc.inova.org
Organizations & group practices 8
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.
-
- Children's Hospital
- Washington, DC
- NPI 1912939703
-
- Internal Medicine Physician
- Falls Church, VA
- NPI 1952320061
-
- Pediatrics Physician
- Fairfax, VA
- NPI 1699119818
-
dba Children's National Medical Associates
- Pediatrics Physician
- Washington, DC
- NPI 1780800128
-
dba Children's National Specialty Pharmacy
- Community/Retail Pharmacy
- Silver Spring, MD
- NPI 1326878349
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Gastroenterology Physician
- Fairfax, VA
- NPI 1205884368
Pediatric Gastroenterology
-
- Anesthesiology Physician
- Charlottesville, VA
- NPI 1902248677
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549324800000",
"number": "1225004815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 744785",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303744785",
"telephone_number": "202-476-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MICHIGAN AVE NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "20010",
"telephone_number": "202-476-5000"
}
],
"practiceLocations": [
{
"address_1": "3022 Williams Dr",
"address_2": "Suite 301",
"address_purpose": "LOCATION",
"city": "Fairfax",
"state": "VA",
"postal_code": "220314600",
"country_code": "US",
"telephone_number": "703-698-8960 x238",
"fax_number": "703-641-8427",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3023 Hamaker Ct Fl 6",
"address_purpose": "LOCATION",
"city": "Fairfax",
"state": "VA",
"postal_code": "220312207",
"country_code": "US",
"telephone_number": "703-876-2788",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEIBOWITZ",
"first_name": "IAN",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-24",
"last_updated": "2019-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "VA",
"license": "0101036573",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "DC",
"license": "MDO46686",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6071787",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.