NPIMap

Individual provider Active NPI

Aysha Habib, MBBS

  • Internal Medicine Physician
  • Henrico, VA
National Provider Identifier
1407053713
Registry record updated Sep 30, 2021
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Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101243074 Issued in VA
Practice address
12320 W Broad St Ste 204
Henrico, VA 23233-7603
Phone
(804) 612-2980
Fax
(804) 762-7102
NPI assigned
Jun 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101243074 VA Primary

Addresses

Primary practice location

12320 W Broad St Ste 204
Henrico, VA 23233-7603

Mailing address

5207 Hickory Park Dr
Suite a
Glen Allen, VA 23059-2624
Phone (804) 612-2980

Other identifiers 1

IdentifierTypeStateIssuer
C06695OtherVAGROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080625000302 VA Practitioner - Internal Medicine 7911078555 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bon Secours Medical Group Richmond Primary Care LLCGroup PAC ID 3476986613, 91 clinicians

Practice addresses (Care Compare)

1362 Tappahannock Blvd
Tappahannock, VA 22560-9309
Phone (804) 443-5378

Hospital & facility affiliations

  • Compassus BSMH Richmond HHA, LLC Home health agency, Richmond, VA, CCN 497026
  • James River Home Health Agency Home health agency, Richmond, VA, CCN 497706
  • At Home Care Home health agency, Mechanicsvlle, VA, CCN 497493
  • Bon Secours St Marys Hospital Hospital, Richmond, VA, CCN 490059
  • Bon Secours Richmond Community Hospital Hospital, Richmond, VA, CCN 490094
  • Bon Secours Memorial Regional Medical Center Hospital, Mechanicsville, VA, CCN 490069
  • Bon Secours St Francis Medical Center Hospital, Midlothian, VA, CCN 490136
  • Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032
  • Sheltering Arms Institute Inpatient rehabilitation facility, Richmond, VA, CCN 493036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101243074VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince May 31, 2021 Accepting new patients
Bon Secours Medical Group Richmond Primary Care LLC Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince May 31, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Commonwealth Counseling Associates Inc Past Accepting new patients

Locations

5207 Hickory Park Dr
Ste A
Glen Allen, VA 23059
Phone (804) 326-4448

12320 W Broad St
Ste 204
Richmond, VA 23233
Phone (804) 612-2980

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

5855 Bremo Rd
Ste 306
Richmond, VA 23226
Phone (804) 287-7644

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

1362 Tappahannock Blvd
Tappahannock, VA 22560
Phone (804) 443-5378

Interoperability endpoints

  • Direct secure messaging: ahabib1151712@direct.bsmhealth.org

Organizations & group practices 5

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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1407053713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5207 HICKORY PARK DR",
            "address_2": "SUITE A",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230592624",
            "telephone_number": "804-612-2980",
            "fax_number": "804-762-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12320 W BROAD ST STE 204",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232337603",
            "telephone_number": "804-612-2980",
            "fax_number": "804-762-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABIB",
        "first_name": "AYSHA",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101243074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06695",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

Verify at the official NPI Registry.