NPIMap

Individual provider Active NPI

Sohail Moussavi, MD

  • Internal Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1265521611
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101235118 Issued in VA
Practice address
12604 Lake Ridge Dr
Woodbridge, VA 22192-2335
Phone
(703) 497-4700
NPI assigned
Oct 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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 0101235118 VA Primary

Addresses

Primary practice location

12604 Lake Ridge Dr
Woodbridge, VA 22192-2335

Mailing address

12604 Lake Ridge Dr
Woodbridge, VA 22192-2335
Phone (703) 497-4700

Other identifiers 1

IdentifierTypeStateIssuer
10018706MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100923000761 VA Practitioner - Internal Medicine 3173410560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardinal Internal Medicine AssociatesGroup PAC ID 2769379148, 7 clinicians

Practice addresses (Care Compare)

12731 Marblestone Dr
Woodbridge, VA 22192-8334
Phone (703) 897-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.28 of 100Reported as group
Quality
86.06
Promoting interoperability
100
Improvement activities
40
Cost
74.87

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardinal Internal Medicine Associates Internal Medicine CurrentSince Oct 16, 2003 Accepting new patients
Medprime, LLC Past Accepting new patients

Locations

608 Garrisonville Rd
Ste 201
Stafford, VA 22554
Phone (540) 659-4157

12604 Lake Ridge Dr
Woodbridge, VA 22192
Phone (703) 497-4700

12731 Marblestone Dr
Ste 200
Woodbridge, VA 22192
Phone (703) 497-4700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FCJAAA

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265521611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12604 LAKE RIDGE DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922335",
            "telephone_number": "703-497-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12604 LAKE RIDGE DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922335",
            "telephone_number": "703-497-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSSAVI",
        "first_name": "SOHAIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101235118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10018706",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.