Individual provider Active NPI

Sabeen Pervaiz, M.D

  • Family Medicine Physician
  • Fairfax, VA
National Provider Identifier
1285879981
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101254065 Issued in VA
Practice address
4041 University Dr Ste 405
Fairfax, VA 22030-3410
Phone
(571) 620-5393
NPI assigned
Dec 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA08798700 NJ
Family Medicine Physician 207Q00000X 0101254065 VA Primary

Addresses

Primary practice location

4041 University Dr Ste 405
Fairfax, VA 22030-3410

Mailing address

4041 University Dr Ste 405
Fairfax, VA 22030-3410
Phone (571) 620-5393

Other practice location 1

999 Vail Rd
Parsippany, NJ 07054-1635
Phone (609) 892-5885

Other practice location 2

8640 Sudley Rd
Suite 203
Manassas, VA 20110-4420
Phone (703) 368-3161

Other identifiers 2

IdentifierTypeStateIssuer
0269433MedicaidNJ
8751404MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, VA, DC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20110719000577 NJ Practitioner - Family Practice 9133397185
I20131221000164 VA Practitioner - Family Practice 9133397185 Reassigns benefits to 1 organization
I20161119000229 DC Practitioner - Family Practice 9133397185 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101254065VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Sep 20, 2016 Accepting new patients
Virginia Covid Clinic CurrentSince Jan 17, 2022 Accepting new patients
Inova Health Care Services CurrentSince Sep 20, 2016 Accepting new patients
Inova Health Care Services Current Accepting new patients

Locations

6201 Centreville Rd
Ste 200
Centreville, VA 20121
Phone (703) 830-5600

4041 University Dr
Ste 405
Fairfax, VA 22030
Phone (571) 351-1796

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1285879981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 UNIVERSITY DR STE 405",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303410",
            "telephone_number": "571-620-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 UNIVERSITY DR STE 405",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303410",
            "telephone_number": "571-620-5393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "999 Vail Rd",
            "address_purpose": "LOCATION",
            "city": "Parsippany",
            "state": "NJ",
            "postal_code": "070541635",
            "country_code": "US",
            "telephone_number": "609-892-5885",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8640 Sudley Rd",
            "address_2": "Suite 203",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201104420",
            "country_code": "US",
            "telephone_number": "703-368-3161",
            "fax_number": "703-368-2498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERVAIZ",
        "first_name": "SABEEN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-09",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA08798700",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101254065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0269433",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8751404",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.