Organization Active NPI

Ascent Integrated Medicine Inc

  • Physical Medicine & Rehabilitation Physician
  • Annandale, VA
National Provider Identifier
1548038391
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ASCENT INTEGRATED MEDICINE INC
Practice address
3301 Woodburn Rd # 206
Annandale, VA 22003-1229
Phone
(703) 538-5455
Fax
(703) 538-6675
NPI assigned
Dec 12, 2023
Last updated
Jan 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Amir AhmadiyarNPI 1912918681
Title
President
Phone
(703) 282-6904

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

3301 Woodburn Rd # 206
Annandale, VA 22003-1229

Mailing address

3301 Woodburn Rd # 206
Annandale, VA 22003-1229
Phone (703) 282-6904

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240306002940 DC Part B Supplier - Clinic/Group Practice 5890131379 Receives reassigned benefits from 3 practitioners
Practice locations: Annandale, VA

National Provider Directory

National Provider Directory

Locations

3301 Woodburn Rd
#206
Annandale, VA 22003
Phone (703) 538-5455

3301 Woodburn Rd
Ste 206
Annandale, VA 22003

6521 Arlington Blvd
Ste 110
Falls Church, VA 22042
Phone (703) 208-7352

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1548038391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 WOODBURN RD # 206",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220031229",
            "telephone_number": "703-282-6904",
            "fax_number": "703-538-6675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 WOODBURN RD # 206",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220031229",
            "telephone_number": "703-538-5455",
            "fax_number": "703-538-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENT INTEGRATED MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-12",
        "last_updated": "2025-01-08",
        "certification_date": "2024-12-28",
        "status": "A",
        "authorized_official_last_name": "AHMADIYAR",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-282-6904"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.