Active NPI
Khesrow Hotak
- Behavior Technician
- Sterling, VA
National Provider Identifier
1316615404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-21-161331
- Practice address
- 32 Regis Cir
Sterling, VA 20164-1374 - Phone
- (571) 337-0794
- NPI assigned
- Sep 2, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-21-161331 | VA | Primary |
Addresses
Primary practice location
32 Regis Cir
Sterling, VA 20164-1374
Mailing address
32 Regis Cir
Sterling, VA 20164-1374
Phone (571) 337-0794
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-21-161331 | VA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DMV Autism & Behavioral Services LLC | Single Specialty | Current | Accepting new patients |
Organizations & group practices 1
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": "1630540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630540800000",
"number": "1316615404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 REGIS CIR",
"city": "STERLING",
"state": "VA",
"postal_code": "201641374",
"telephone_number": "571-337-0794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 REGIS CIR",
"city": "STERLING",
"state": "VA",
"postal_code": "201641374",
"telephone_number": "571-337-0794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOTAK",
"first_name": "KHESROW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-09-02",
"last_updated": "2021-09-02",
"certification_date": "2021-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "VA",
"license": "RBT-21-161331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.