Individual provider Active NPI

Farouk Elkassed, DPT

  • Physical Therapist
  • Fairfax, VA
National Provider Identifier
1275668808
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305004573 Issued in VA
Practice address
10340 Democracy LN
Suite 106
Fairfax, VA 22030-2518
Phone
(703) 865-5538
NPI assigned
Feb 23, 2007
Last updated
Jun 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305004573 VA Primary

Addresses

Primary practice location

10340 Democracy LN
Suite 106
Fairfax, VA 22030-2518

Mailing address

10340 Democracy LN
Suite 106
Fairfax, VA 22030-2518
Phone (703) 865-5538

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090605000015 DC Practitioner - Physical Therapist in Private Practice 7911057302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10340 Democracy LN
Suite 106
Fairfax, VA 22030-2518
Phone (703) 865-5538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Results Rehab & Fitness, Inc Physical Therapist PastSince Jul 1, 2012 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 3

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1275668808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10340 DEMOCRACY LN",
            "address_2": "SUITE 106",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302518",
            "telephone_number": "703-865-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10340 DEMOCRACY LN",
            "address_2": "SUITE 106",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302518",
            "telephone_number": "703-865-5538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKASSED",
        "first_name": "FAROUK",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305004573",
            "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 Jun 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.