Azadeh Koochekzadeh, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

101230323 Issued in VA

Practice address

4660 Kenmore Ave
Ste 500
Alexandria, VA 22304

Phone

(703) 212-6600

Fax

(703) 212-6606

NPI assigned

Mar 15, 2006

Last updated

Apr 11, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: azadeh.koochekzadeh@allp.eclinicaldirectplus.com

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.

• Alexandria Lake Ridge Pediatrics

  • Pediatrics Physician
  • Alexandria, VA
  • NPI 1649215955
  NPD (past)

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1609845429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 OSAGE ST",
            "address_2": "STE 104",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22302",
            "telephone_number": "703-212-6600",
            "fax_number": "703-931-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "address_2": "STE 500",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22304",
            "telephone_number": "703-212-6600",
            "fax_number": "703-212-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOCHEKZADEH",
        "first_name": "AZADEH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "101230323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6792898",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elvis Ndenge Kometa
• Regina Grace Komlagah
• David Alan Kon, PA-C
• Kimberly Kongkasuwan, MD
• Konterra Counseling & Psychological Services, LLC
• Georgina Thelma Koomson, LPN
• Jahkia K Koomson, PA
• Rubby Koomson, FNP-C
• Noah Andrew Koon, M.D.
• Martha Ewing Kophazi, R.PH.

• Pediatrics Physician in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.