Individual provider Active NPI

Abraham Yimer Asmamaw, MD

  • Physical Medicine & Rehabilitation Physician
  • Alexandria, VA
National Provider Identifier
1417912593
Registry record updated Mar 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0101223994 Issued in VA
Practice address
4600 King St
Ste 4R
Alexandria, VA 22302-1277
Phone
(703) 820-8050
Fax
(703) 820-8720
NPI assigned
Apr 20, 2006
Last updated
Mar 31, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 0101223994 VA Primary

Addresses

Primary practice location

4600 King St
Ste 4R
Alexandria, VA 22302-1277

Mailing address

PO Box 11529
Alexandria, VA 22312-0529
Phone (703) 820-8050

Other identifiers 1

IdentifierTypeStateIssuer
10006171MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100503000370 DC Practitioner - Physical Medicine and Rehabilitation 2769394204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5350 Shawnee Rd
Suite 305
Alexandria, VA 22312-2371
Phone (703) 914-8050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Care and Rehab.,PC Physical Medicine & Rehabilitation CurrentSince Jul 24, 2002 Accepting new patients
Imtiyaz I Kapadwala DPM PC Past Accepting new patients

Locations

4600 King St
Ste 4R
Alexandria, VA 22302
Phone (703) 820-8050

5350 Shawnee Rd
Ste 305
Alexandria, VA 22312
Phone (703) 914-8050

1075 Garrisonville Rd
Ste 115
Stafford, VA 22556
Phone (540) 288-9888

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206921600000",
    "number": "1417912593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11529",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223120529",
            "telephone_number": "703-820-8050",
            "fax_number": "703-820-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 KING ST",
            "address_2": "STE 4R",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021277",
            "telephone_number": "703-820-8050",
            "fax_number": "703-820-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASMAMAW",
        "first_name": "ABRAHAM",
        "middle_name": "YIMER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2008-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101223994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10006171",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.