Individual provider Active NPI

Mitra Zameni, MD

  • Obstetrics & Gynecology Physician
  • Fairfax, VA
National Provider Identifier
1609147115
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0101261606 Issued in VA
Practice address
10875 Main Street Suit 210
Fairfax, VA 22030
Phone
(703) 218-2403
NPI assigned
Jan 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 0101261606 VA Primary

Addresses

Primary practice location

10875 Main Street Suit 210
Fairfax, VA 22030

Mailing address

10875 Main Street Suit 210
Fairfax, VA 22030
Phone (703) 218-2403

Other identifiers 1

IdentifierTypeStateIssuer
03734214MedicaidNY

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
I20180416002529 DC Practitioner - Obstetrics/Gynecology 3476771403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10875 Main St
Suite 210
Fairfax, VA 22030-4732
Phone (703) 218-2403

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Choice OBGYN LLC Obstetrics & Gynecology CurrentSince Mar 2, 2018 Accepting new patients

Locations

10875 Main St
Ste 210
Fairfax, VA 22030
Phone (703) 218-2403

100 Elden St
Ste 14
Herndon, VA 20170
Phone (703) 471-7733

Organizations & group practices 1

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": "1326672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1609147115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10875 MAIN STREET SUIT 210",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-218-2403",
            "fax_number": "703-267-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10875 MAIN STREET SUIT 210",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-218-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMENI",
        "first_name": "MITRA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-16",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101261606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03734214",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.