Individual provider Active NPI

Alexander Rostam Kheradi, M.D.

  • Emergency Medicine Physician
  • Joint Base Andrews, MD
National Provider Identifier
1417215799
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D0077343 Issued in MD
Practice address
1050 West Perimeter Road
Joint Base Andrews, MD 20762
Phone
(240) 857-2229
NPI assigned
Apr 24, 2012
Last updated
May 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D0077343 MD Primary

Addresses

Primary practice location

1050 West Perimeter Road
Joint Base Andrews, MD 20762

Mailing address

409 S Columbus St
Alexandria, VA 22314-3605
Phone (610) 324-0577

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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150922002651 DC Practitioner - Emergency Medicine 3678880754 Reassigns benefits to 4 organizations
I20210928000010 MD Practitioner - Sports MedicinePractitioner - Emergency Medicine 3678880754 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wake Forest University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians
Medstar Urgent Care LLCGroup PAC ID 9335303155, shared by 36 NPIs, 300 clinicians

Practice addresses (Care Compare)

1120 20TH St NW
Medstar at Lafayette
Washington, DC 20036-3406
Phone (202) 416-2000

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

12 Medstar Blvd
Bel Air, MD 21015-1798
Phone (410) 877-8087

1420 Beverly Rd
MC Lean, VA 22101-3732
Phone (571) 786-6548

1805 Columbia Rd NW
Washington, DC 20009-2001
Phone (202) 797-4960

3001 S Hanover St
Baltimore, MD 21225-1233
Phone (410) 350-3200

3007 Tilden St NW
Suite 5N
Washington, DC 20008-3030

5454 Wisconsin Ave
Chevy Chase, MD 20815-6901
Phone (877) 677-3627

6410 Rockledge Dr
Bethesda, MD 20817-1844

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as group
Quality
80.29
Promoting interoperability
100
Improvement activities
40
Cost
75.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0077343MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine CurrentSince Oct 6, 2019 Accepting new patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2021 Accepting new patients
Medstar Urgent Care LLC CurrentSince Oct 10, 2021 Accepting new patients
WHC Emerg Phys CurrentSince Aug 5, 2014 Accepting new patients
WHC Physician Group LLC CurrentSince Aug 5, 2014 Accepting new patients
Medstar Urgent Care, LLC CurrentSince Oct 10, 2021 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Oct 6, 2019 Accepting new patients
Medstar Urgent Care LLC Current Accepting new patients
Medstar Urgent Care LLC CurrentSince Oct 10, 2021 Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

1805 Columbia Rd NW
Washington, DC 20009
Phone (202) 797-4950

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

12 Medstar Blvd
Bel Air, MD 21015
Phone (410) 877-8087

3001 S Hanover St
Brooklyn Park, MD 21225
Phone (410) 350-3200

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

11355 Pembrooke Sq
Ste 108
Waldorf, MD 20603
Phone (202) 877-6733

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

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

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

2000 15th St N
Ste 600
Arlington, VA 22201
Phone (202) 416-2000

Organizations & group practices 10

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1417215799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S COLUMBUS ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223143605",
            "telephone_number": "610-324-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 WEST PERIMETER ROAD",
            "city": "JOINT BASE ANDREWS",
            "state": "MD",
            "postal_code": "20762",
            "telephone_number": "240-857-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHERADI",
        "first_name": "ALEXANDER",
        "middle_name": "ROSTAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-24",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0077343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joint Base Andrews, MD

Sources for this page

Verify at the official NPI Registry.