Individual provider Active NPI

Kaneeze-Fatema Altafhusen Bukhari, MD

  • Pediatrics Physician
  • Leesburg, VA
National Provider Identifier
1386822617
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
002848 Issued in GA
Practice address
823 S King St Ste F
Leesburg, VA 20175-3916
Phone
(703) 777-5222
Fax
(703) 777-5144
NPI assigned
Feb 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 002848 GA Primary

Addresses

Primary practice location

823 S King St Ste F
Leesburg, VA 20175-3916

Mailing address

823 S King St Ste F
Leesburg, VA 20175-3916
Phone (703) 777-5222

Other practice location 1

46165 Westlake Dr Ste 210
Sterling, VA 20165-5872
Phone (703) 777-5222

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
002848GAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Trusted Doctors LLC Pediatrics Past 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": "1202428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1386822617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 S KING ST STE F",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201753916",
            "telephone_number": "703-777-5222",
            "fax_number": "703-777-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 S KING ST STE F",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201753916",
            "telephone_number": "703-777-5222",
            "fax_number": "703-777-5144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46165 Westlake Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201655872",
            "country_code": "US",
            "telephone_number": "703-777-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUKHARI",
        "first_name": "KANEEZE-FATEMA",
        "middle_name": "ALTAFHUSEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-08",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "002848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.