Individual provider Active NPI

Azar Mahdavi, FNP-BC

  • Nurse Practitioner
  • Leesburg, VA
National Provider Identifier
1336932482
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
24193204 Issued in VA
Practice address
44055 Riverside Pkwy Ste 106
Leesburg, VA 20176-5155
Phone
(844) 466-8244
NPI assigned
May 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 24193204 VA Primary

Addresses

Primary practice location

44055 Riverside Pkwy Ste 106
Leesburg, VA 20176-5155

Mailing address

21250 Windmill Parc Dr Unit 104
Sterling, VA 20166-6699
Phone (703) 470-7841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251006003644 DC Practitioner - Nurse Practitioner 2860999091 Reassigns benefits to 1 organization
I20251106003692 VA Practitioner - Nurse Practitioner 2860999091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

44055 Riverside Pkwy
Suite 106
Leesburg, VA 20176-5155
Phone (703) 858-6202

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24193204VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Sep 14, 2025 Accepting new patients
Inova Health Care Services CurrentSince Sep 14, 2025 Accepting new patients

Locations

6354 Walker Ln
Alexandria, VA 22310
Phone (703) 608-5808

8081 Innovation Park Dr
#301
Fairfax, VA 22031

3620 Joseph Siewick Dr
Ste 406
Fairfax, VA 22033
Phone (703) 429-2109

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

44055 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 724-7530

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

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

44055 Riverside Pkwy
Ste 106
Leesburg, VA 20176
Phone (703) 858-6202

Interoperability endpoints

  • Direct secure messaging: amahdavi645470@soc.inova.org

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1336932482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21250 WINDMILL PARC DR UNIT 104",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201666699",
            "telephone_number": "703-470-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44055 RIVERSIDE PKWY STE 106",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201765155",
            "telephone_number": "844-466-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHDAVI",
        "first_name": "AZAR",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "24193204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.