Active NPI
Ishtiaq Ahmad, MD
- Neurology Physician
- Reston, VA
National Provider Identifier
1326008384
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Apr 18, 2019.
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 010230245
- Practice address
- 1860 Town Center Dr
Suite 320
Reston, VA 20190-5896 - Phone
- (703) 348-7207
- Fax
- (703) 435-1844
- NPI assigned
- Mar 24, 2006
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | D0061334 | MD | |
| Vascular Neurology Physician | 2084V0102X | 242 | VA | |
| Neurology Physician | 2084N0400X | 010230245 | VA | Primary |
| Neuromusculoskeletal Medicine & OMM Physician | 204D00000X | 3089 | VA |
Addresses
Primary practice location
1860 Town Center Dr
Suite 320
Reston, VA 20190-5896
Mailing address
1860 Town Center Dr
Suite 320
Reston, VA 20190-5896
Phone (703) 348-7207
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010358906 | Medicaid | VA | |
| 404642100 | Medicaid | MD | |
| 6432-0001 | Other | CAREFIRST |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3089 | VA | MD | Neuromusculoskeletal Medicine & OMM Physician |
| D0061334 | MD | MD | Neurology Physician |
| 010230245 | VA | MD | Neurology Physician |
| 242 | VA | MD | Vascular Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Physician Services, LLLP | Past | Accepting new patients | |
| St. Agnes Healthcare, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Westminster, MD
- NPI 1457302713
-
- General Acute Care Hospital
- Baltimore, MD
- NPI 1245274901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317254400000",
"number": "1326008384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 TOWN CENTER DR",
"address_2": "SUITE 320",
"city": "RESTON",
"state": "VA",
"postal_code": "201905896",
"telephone_number": "703-348-7207",
"fax_number": "703-435-1844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1860 TOWN CENTER DR",
"address_2": "SUITE 320",
"city": "RESTON",
"state": "VA",
"postal_code": "201905896",
"telephone_number": "703-348-7207",
"fax_number": "703-435-1844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMAD",
"first_name": "ISHTIAQ",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-24",
"last_updated": "2011-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MD",
"license": "D0061334",
"primary": false
},
{
"code": "2084V0102X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Vascular Neurology",
"state": "VA",
"license": "242",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "VA",
"license": "010230245",
"primary": true
},
{
"code": "204D00000X",
"taxonomy_group": "",
"desc": "Neuromusculoskeletal Medicine & OMM",
"state": "VA",
"license": "3089",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010358906",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "404642100",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST",
"identifier": "6432-0001",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.