Individual provider Active NPI

Faris Haddad, M.D.

  • Diagnostic Radiology Physician
  • Fairfax, VA
National Provider Identifier
1538463724
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101251648 Issued in VA
Practice address
2722 Merrilee Dr
Ste 230
Fairfax, VA 22031-4420
Phone
(703) 698-4444
Fax
(703) 204-0116
NPI assigned
Jan 2, 2011
Last updated
Oct 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD037929 DC
Diagnostic Radiology Physician 2085R0202X 0101251648 VA Primary

Addresses

Primary practice location

2722 Merrilee Dr
Ste 230
Fairfax, VA 22031-4420

Mailing address

2722 Merrilee Dr
Ste 230
Fairfax, VA 22031-4420
Phone (703) 698-4444

Other identifiers 3

IdentifierTypeStateIssuer
3810023748MedicaidWV
316913OtherVAKAISER PERMANENTE
1538463724MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20120906000077 VA Practitioner - Diagnostic Radiology 0042498545 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
67.5 of 100Reported as group
Quality
58.12
Improvement activities
40
Cost
68.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD037929DCMDDiagnostic Radiology Physician

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": "1293926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1538463724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2722 MERRILEE DR",
            "address_2": "STE 230",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314420",
            "telephone_number": "703-698-4444",
            "fax_number": "703-204-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2722 MERRILEE DR",
            "address_2": "STE 230",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314420",
            "telephone_number": "703-698-4444",
            "fax_number": "703-204-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "FARIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-02",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "DC",
            "license": "MD037929",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101251648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810023748",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER PERMANENTE",
            "identifier": "316913",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538463724",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.