Organization Active NPI

North Eastern Virginia Medical, PLLC

  • Internal Medicine Physician
  • Alexandria, VA
National Provider Identifier
1245556778
Registry record updated Apr 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101245174 Issued in VA
Legal business name
NORTH EASTERN VIRGINIA MEDICAL, PLLC
Practice address
4660 Kenmore Ave
Suite 600
Alexandria, VA 22304-1313
Phone
(703) 303-2806
Fax
(703) 532-1615
NPI assigned
Apr 8, 2010
Last updated
Apr 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2010

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

Authorized official

Name
Dr. Sahba Yasin
Title
President/Ownder
Phone
(703) 303-2806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101245174 VA Primary

Addresses

Primary practice location

4660 Kenmore Ave
Suite 600
Alexandria, VA 22304-1313

Mailing address

2122 McConvey PL
Falls Church, VA 22043-3068
Phone (703) 303-2806

Other identifiers 1

IdentifierTypeStateIssuer
1568432987OtherPROVIDER INDIVIDUAL NPI

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1245556778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 MCCONVEY PL",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220433068",
            "telephone_number": "703-303-2806",
            "fax_number": "703-532-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "address_2": "SUITE 600",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041313",
            "telephone_number": "703-303-2806",
            "fax_number": "703-532-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH EASTERN VIRGINIA MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "YASIN",
        "authorized_official_first_name": "SAHBA",
        "authorized_official_title_or_position": "PRESIDENT/OWNDER",
        "authorized_official_telephone_number": "703-303-2806",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101245174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER INDIVIDUAL NPI",
            "identifier": "1568432987",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; 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.