Individual provider Active NPI

Ishtiaq Ahmad, MD

  • Neurology Physician
  • Reston, VA
National Provider Identifier
1326008384
Registry record updated Sep 29, 2011
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.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
010230245 Issued in VA
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

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
010358906MedicaidVA
404642100MedicaidMD
6432-0001OtherCAREFIRST

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. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3089VAMDNeuromusculoskeletal Medicine & OMM Physician
D0061334MDMDNeurology Physician
010230245VAMDNeurology Physician
242VAMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.