Ehsan Habibpour, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0101250561 Issued in VA

Practice address

6862 Elm St Ste 205
MC Lean, VA 22101

Phone

(703) 821-1073

Fax

(703) 288-0767

NPI assigned

Jun 29, 2007

Last updated

Feb 11, 2019By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 13, 2019 through May 13, 2027

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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.

• McLean Counseling Center

  • Psychiatry Physician
  • McLean, VA
  • NPI 1417495375

  Multi-Specialty

  NPD (past) Authorized official
• Brain Bloom Neurotherapy Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • McLean, VA
  • NPI 1659113322
  NPD

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1396942603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6862 ELM ST STE 205",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013857",
            "telephone_number": "703-821-1073",
            "fax_number": "703-288-0767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6862 ELM ST STE 205",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "22101",
            "telephone_number": "703-821-1073",
            "fax_number": "703-288-0767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Slaters Ln Ste 103",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223141176",
            "country_code": "US",
            "telephone_number": "571-800-9909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HABIBPOUR",
        "first_name": "EHSAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101250561",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101250561",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Gumble, PA-C
• Gaurav Gupta
• Ronald E Gurney, MD
• Cecilia Gyllenhoff, DDS
• Christine H Haas, M.S., C.N.S., C.P.T.
• Had Management LLC (Hearing Doctors)
• Alia Haddad
• Estee Hafassa
• Logaina Hafez, MA, GCDF
• Tuleen Hajoun

• Psychiatry Physician in McLean, VA
• Providers in McLean, VA by specialty
• Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.