Individual provider Active NPI

Wasim Fawzi Raslan, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Alexandria, VA
National Provider Identifier
1487493359
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036074036 Issued in IL
Practice address
4689 Longstreet LN Apt 303
Alexandria, VA 22311-4934
Phone
(571) 480-0086
NPI assigned
May 21, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036074036 IL Primary

Addresses

Primary practice location

4689 Longstreet LN Apt 303
Alexandria, VA 22311-4934

Mailing address

4689 Longstreet LN Apt 303
Alexandria, VA 22311-4934
Phone (571) 480-0086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250612003801 FL Practitioner - Pathology 5496266967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Regional Laboratories Pathology Services, LLCGroup PAC ID 9133244346, 132 clinicians

Practice addresses (Care Compare)

1800 SE Tiffany Ave
Port Saint Lucie, FL 34952-7521
Phone (772) 807-6303

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036074036ILMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Regional Laboratories Pathology Services, LLC Anatomic Pathology & Clinical Pathology CurrentSince Apr 28, 2025 Accepting new patients
Pathmed Associates LLC Anatomic Pathology & Clinical Pathology Current Accepting new patients

Locations

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

3600 S Highlands Ave
Sebring, FL 33870
Phone (863) 385-6101

11375 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 596-4209

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1716249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1487493359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4689 LONGSTREET LN APT 303",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223114934",
            "telephone_number": "571-480-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4689 LONGSTREET LN APT 303",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223114934",
            "telephone_number": "571-480-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASLAN",
        "first_name": "WASIM",
        "middle_name": "FAWZI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036074036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.