Individual provider Active NPI

Nasrin Ejtemaee, M.D.

  • Family Medicine Physician
  • McLean, VA
National Provider Identifier
1497850077
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101221367 Issued in VA
Practice address
8375 Greensboro Dr # a
McLean, VA 22102-3529
Phone
(703) 893-8345
Fax
(703) 356-2730
NPI assigned
Sep 14, 2006
Last updated
Sep 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101221367 VA Primary

Addresses

Primary practice location

8375 Greensboro Dr # a
McLean, VA 22102-3529

Mailing address

8375 Greensboro Dr # a
McLean, VA 22102-3529
Phone (703) 893-8345

Other identifiers 1

IdentifierTypeStateIssuer
5642329MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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
I20111115000243 VA Practitioner - Family Practice 2264606946 Reassigns benefits to 1 organization
I20120227000258 DC Practitioner - Family Practice 2264606946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

44121 Harry Byrd Hwy
Suite 285
Ashburn, VA 20147-5673
Phone (703) 729-4222

8375 A Greensboro Dr
MC Lean, VA 22102-3529
Phone (703) 893-8345

8375 Greensboro Dr
A
MC Lean, VA 22102-3529

8375 Greensboro Dr a
McLean, VA 22102-3529

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nasrin Ejtemaee MD PC CurrentSince Oct 1, 1999 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Privia Medical Group, LLC PastSince Sep 22, 2011 Accepting new patients

Locations

8375 Greensboro Dr
#A
McLean, VA 22102
Phone (703) 893-8345

8375A Greensboro Dr
McLean, VA 22102
Phone (703) 893-8345

Interoperability endpoints

  • Direct secure messaging: etjemaeenasrin@131208.advancedmd-direct.com

Organizations & group practices 3

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 2

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1497850077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8375 GREENSBORO DR # A",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221023529",
            "telephone_number": "703-893-8345",
            "fax_number": "703-356-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8375 GREENSBORO DR # A",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221023529",
            "telephone_number": "703-893-8345",
            "fax_number": "703-356-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJTEMAEE",
        "first_name": "NASRIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101221367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5642329",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

Verify at the official NPI Registry.