Kevin Andrew Azzam, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0102205381 Issued in VA

Practice address

3300 Gallows Rd
Department of Medicine, Inova Fairfax Hospital
Falls Church, VA 22042-3307

Phone

(703) 776-2173

Fax

(703) 776-3020

NPI assigned

Jun 23, 2014

Last updated

Sep 4, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC2 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 2

Specialty

HospitalistAlso: Internal Medicine

Education

Lake Erie College of Osteopathic Medicine, Erie, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oxbow Physician Services LLCGroup PAC ID 1850883513, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ballad Health Hospice Hospice, Abingdon, VA, CCN 491542
• Johnston Memorial Hospital Hospital, Abingdon, VA, CCN 490053

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Oxbow Physician Services LLC

  • Hospitalist Physician
  • Abingdon, VA
  • NPI 1942183991

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of Fredericksburg, LLC

  • Internal Medicine Physician
  • Fredericksburg, VA
  • NPI 1447577572
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Virginia LLC

  • Internal Medicine Physician
  • Winchester, VA
  • NPI 1770756991

  DC

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Johnston Memorial Hospital, Inc

  • General Acute Care Hospital
  • Abingdon, VA
  • NPI 1104812684
  Care Compare affiliation
• Mountain States Health Alliance

  dba Ballad Health Hospice

  • Inpatient Hospice
  • Abingdon, VA
  • NPI 1336635192
  Care Compare affiliation

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1295140879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "address_2": "DEPARTMENT OF MEDICINE, INOVA FAIRFAX HOSPITAL",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22042",
            "telephone_number": "703-776-2173",
            "fax_number": "703-776-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "address_2": "DEPARTMENT OF MEDICINE, INOVA FAIRFAX HOSPITAL",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-776-2173",
            "fax_number": "703-776-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZZAM",
        "first_name": "KEVIN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102205381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Ayscue, DPT
• Allan Ali Azarion, MD
• Eduardo M Azcarate, PHD
• Fatima Zehra Aziz-Ashraf, M.D.
• Wali Azizi, M.D.
• B&B Home Healthcare LLC
• Frances Babb
• Isabelle Babington, O.T.
• Frieda E Bacha, M.D.
• Laura Bachor, DPT

• Internal Medicine Physician in Falls Church, VA
• Providers in Falls Church, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.