Individual provider Active NPI

Muktar Trawalley

  • Psychiatric/Mental Health Nurse Practitioner
  • Falls Church, VA
National Provider Identifier
1558067942
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024186489 Issued in VA
Practice address
3300 Gallows Rd
Falls Church, VA 22042-3300
Phone
(703) 776-6850
NPI assigned
Feb 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024186489 VA Primary

Addresses

Primary practice location

3300 Gallows Rd
Falls Church, VA 22042-3300

Mailing address

15685 Palermo Ter
Woodbridge, VA 22191-4289
Phone (712) 975-9315

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: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230804001875 VA Practitioner - Nurse Practitioner 9830550979 Reassigns benefits to 1 organization
I20231014000638 DC Practitioner - Nurse Practitioner 9830550979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

22505 Landmark CT
Suite 210B
Ashburn, VA 20148-6502
Phone (571) 623-3500

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

8505 Arlington Blvd
Fairfax, VA 22031-4630

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jul 9, 2023 Accepting new patients
Inova Health Care Services CurrentSince Jul 9, 2023 Accepting new patients

Locations

22505 Landmark Ct
Ste 210B
Ashburn, VA 20148
Phone (571) 612-6350

8505 Arlington Blvd
Ste 200
Fairfax, VA 22031
Phone (703) 698-8525

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

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.

NPI Registry JSON

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1558067942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15685 PALERMO TER",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221914289",
            "telephone_number": "712-975-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423300",
            "telephone_number": "703-776-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAWALLEY",
        "first_name": "MUKTAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024186489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.