Individual provider Active NPI

Ataharul H Mannan, DO

  • Internal Medicine Physician
  • Vienna, VA
National Provider Identifier
1508327578
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0102207263 Issued in VA
Practice address
2671B Avenir PL
Vienna, VA 22180-7176
Phone
(703) 207-8600
Fax
(703) 207-9224
NPI assigned
Mar 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0102207263 VA Primary

Addresses

Primary practice location

2671B Avenir PL
Vienna, VA 22180-7176

Mailing address

PO Box 37189
Baltimore, MD 21297-3189
Phone (571) 423-5699

Other practice location 1

55 Arch St Ste 1B
Akron, OH 44304-1436
Phone (330) 375-3315

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
I20230113000448 DC Practitioner - Internal Medicine 6103152921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Physician Partners LLCGroup PAC ID 2466581772, 258 clinicians

Practice addresses (Care Compare)

2671 Avenir PL
Suite B
Vienna, VA 22180-7485
Phone (703) 207-8600

3914 Centreville Rd
Suite 250
Chantilly, VA 20151-3290
Phone (703) 435-1223

8503 Arlington Blvd
Suite 400
Fairfax, VA 22031-4629
Phone (571) 472-6253

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.98 of 100Reported as apm
Quality
87.97
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Physician Partners, LLC CurrentSince Sep 19, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Inova Physician Partners, Inc. - Specialists PastSince Sep 25, 2022 Accepting new patients

Locations

3914 Centreville Rd
Ste 250
Chantilly, VA 20151
Phone (703) 435-1223

8503 Arlington Blvd
Fl 4
Fairfax, VA 22031
Phone (703) 938-0363

Interoperability endpoints

  • Direct secure messaging: amannan1091366@soc.inova.org

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 and National Provider Directory roles.

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": "1553904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1508327578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37189",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973189",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2671B AVENIR PL",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221807176",
            "telephone_number": "703-207-8600",
            "fax_number": "703-207-9224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Arch St Ste 1B",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443041436",
            "country_code": "US",
            "telephone_number": "330-375-3315",
            "fax_number": "330-375-7779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNAN",
        "first_name": "ATAHARUL",
        "middle_name": "H",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-30",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102207263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

Verify at the official NPI Registry.