Kaniz Fatema, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101241486 Issued in VA

Practice address

12581 Milstead Way Ste 103
Woodbridge, VA 22192-5446

Phone

(703) 437-6060

NPI assigned

Jul 2, 2007

Last updated

Nov 5, 2018By the provider in NPPES

Sex

Female

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

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 1

Specialty

Interventional Pain Management

Education

Other

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virginia Urgent Care LLCGroup PAC ID 2062572456, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Northern Virginia Medical Center Hospital, Woodbridge, VA, CCN 490113

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Virginia Urgent Care LLC

  dba NextCare Urgent Care

  • Urgent Care Clinic/Center
  • Fredericksburg, VA
  • NPI 1487838652
  Medicare reassignment Care Compare group NPD

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

• Potomac Hospital Corporation of Prince William

  dba Sentara Northern Virginia Medical Center

  • General Acute Care Hospital
  • Woodbridge, VA
  • NPI 1548366404
  Care Compare affiliation

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1356548366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9527 PARSONAGE LN",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220792776",
            "telephone_number": "703-646-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12581 MILSTEAD WAY STE 103",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925446",
            "telephone_number": "703-437-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATEMA",
        "first_name": "KANIZ",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "VA",
            "license": "0101241486",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101241486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon M Farber, MD
• Maidah Farooq, DDS
• Muazzam Farooq
• Atoussa Farough, MD
• Zohreh Farzad
• Hadi Fathalikhani, PT
• Fatherandsoncom
• Andre F Feltren, OTR/L
• Yordanos Fente
• Breanna Ferguson

• Family Medicine Physician in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; 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.