Individual provider Active NPI

Mohamed Mardini, MD

  • Pediatric Cardiology Physician
  • Manassas, VA
National Provider Identifier
1285612887
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
0101023633 Issued in VA
Practice address
8100 Ashton Ave
Suite 200
Manassas, VA 20109-5688
Phone
(703) 335-8750
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 0101023633 VA Primary
Pediatric Cardiology Physician 2080P0202X D0015898 MD

Addresses

Primary practice location

8100 Ashton Ave
Suite 200
Manassas, VA 20109-5688

Mailing address

8100 Ashton Ave
Suite 200
Manassas, VA 20109-5688
Phone (703) 331-0300

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

State licenses

LicenseStateTypeSpecialty
D0015898MDMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services PastSince Jan 1, 1990 Accepting new patients
Inova Health Care Services PastSince Jan 1, 1990 Accepting new patients
Inova Health Care Services PastSince Jan 1, 1990 Accepting new patients
Inova Health Care Services PastSince Jan 1, 1990 Accepting new patients
Inova Health Care Services PastSince Jan 1, 1990 Accepting new patients
Alexandria Hospital Inc Accounting Dept PastSince Jan 1, 1990 Accepting new patients
Inova Health Care Services PastSince Jan 1, 1990 Accepting new patients
Inova Health Care Services PastSince Jan 1, 1990 Accepting new patients
Inova Health Care Services PastSince Jan 1, 1990 Accepting new patients
Inova Health Care Services PastSince Jan 1, 1990 Accepting new patients
Inova Health Care Services PastSince Jan 1, 1990 Accepting new patients
Inova Health Care Services PastSince Jan 1, 1990 Accepting new patients
Inova Health Care Services PastSince Jan 1, 1990 Accepting new patients
Inova Health Care Services PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1285612887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 ASHTON AVE",
            "address_2": "SUITE 200",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095688",
            "telephone_number": "703-331-0300",
            "fax_number": "703-331-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 ASHTON AVE",
            "address_2": "SUITE 200",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095688",
            "telephone_number": "703-335-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDINI",
        "first_name": "MOHAMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "VA",
            "license": "0101023633",
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MD",
            "license": "D0015898",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.