Individual provider Active NPI

Samineh Asgari

  • Medical Physician Assistant
  • Washington, DC
National Provider Identifier
1407502685
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA200001946 Issued in DC
Practice address
900 23Rd St NW
Washington, DC 20037-2342
Phone
(202) 714-4911
NPI assigned
Feb 25, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0008363 MD
Physician Assistant 363A00000X 0110008442 VA
Medical Physician Assistant 363AM0700X PA200001946 DC Primary

Addresses

Primary practice location

900 23Rd St NW
Washington, DC 20037-2342

Mailing address

12111 Darnestown Rd
Gaithersburg, MD 20878-3211
Phone (301) 782-2224

Other practice location 1

12111 Darnestown Rd
Gaithersburg, MD 20878-3211
Phone (301) 782-2224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20221005001521 DC Practitioner - Physician Assistant 9335525914 Reassigns benefits to 3 organizations
I20230922002221 MD Practitioner - Physician Assistant 9335525914 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0008363MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Jun 24, 2022 Accepting new patients
Medstar Urgent Care LLC CurrentSince Sep 24, 2023 Accepting new patients
Medstar Urgent Care LLC CurrentSince Sep 24, 2023 Accepting new patients
Privia Medical Group, LLC CurrentSince Jun 24, 2022 Accepting new patients
Medstar Urgent Care, LLC CurrentSince Sep 24, 2023 Accepting new patients

Locations

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

3007 Tilden St NW
Ste 5N
Washington, DC 20008

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

12111 Darnestown Rd
Gaithersburg, MD 20878
Phone (301) 926-3020

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

2070 Chain Bridge Rd
Ste 150
Vienna, VA 22182
Phone (703) 794-5376

Organizations & group practices 7

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": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1407502685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12111 DARNESTOWN RD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208783211",
            "telephone_number": "301-782-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 23RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200372342",
            "telephone_number": "202-714-4911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12111 Darnestown Rd",
            "address_purpose": "LOCATION",
            "city": "Gaithersburg",
            "state": "MD",
            "postal_code": "208783211",
            "country_code": "US",
            "telephone_number": "301-782-2224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASGARI",
        "first_name": "SAMINEH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008363",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008442",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA200001946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.