Khodaidad H Basharmal, M.D.
Individual provider Active NPI Internal Medicine Physician · Sterling, VA
NPI 1609855279 · NPPES record last updated Feb 11, 2021
Key facts
- NPI
- 1609855279
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 0101231457 (VA)
- Practice address
- 47100 Community PLZ
Suite 100
Sterling, VA 20164-1826 - Phone
- (804) 968-5700
- Fax
- (804) 217-7991
- NPI assigned
- Jan 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 28
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1969
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Patient First Richmond Medical Group PLLC
Practice addresses (Care Compare)
2199 Old Bridge Rd
Woodbridge, VA 22192-2911
Phone (703) 357-9707
3918 Centreville Rd
Chantilly, VA 20151-3224
Phone (703) 657-6925
47100 Community PLZ
Suite 100
Sterling, VA 20164-1821
Phone (703) 880-1403
60 Prosperity LN
Stafford, VA 22556-4605
Phone (540) 658-2811
601 Potomac Station Dr
Leesburg, VA 20176-1816
Phone (703) 840-1396
6311 Richmond Hwy
Alexandria, VA 22306-6410
Phone (703) 647-6087
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA, DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110308000653 | VA | Practitioner - Internal Medicine | 8921280231 | Reassigns benefits to 2 organizations |
| I20131219001637 | DC | Practitioner - Internal Medicine |
8921280231 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101231457 | VA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Patient First Richmond Medical Group PLLC | Current |
Accepting new patients | |
| Patient First Richmond Medical Group PLLC | Current |
Accepting new patients | |
| Medics USA Medical Center, Inc | Current |
Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Medics USA, Inc | Past | Accepting new patients |
Locations
6311 Richmond Hwy
Alexandria, VA 22306
Phone (703) 647-6087
44050 Ashburn Shopping Plz
Ste 179
Ashburn, VA 20147
Phone (540) 338-3360
5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355
5000 Cox Rd
Ste 100
Glen Allen, VA 23060
Phone (804) 822-4383
601 Potomac Station Dr NE
Leesburg, VA 20176
Phone (703) 840-1396
47100 Community Plz
Ste 100
Sterling, VA 20164
Phone (703) 880-1403
Interoperability endpoints
- vaexchange@patientfirstclinics.com
- https://fhir4.healow.com/fhir/r4/CECEAD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101231457 | VA | Yes |
Addresses
Primary practice location
47100 Community PLZ
Suite 100
Sterling, VA 20164-1826
Mailing address
5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | VAExchange@patientfirstclinics.com |
Other providers in Sterling, VA
- Samyra Barbour
- Duncan Stewart Barlow
- Joanna Marie Barnett
- Monica Barton
- Kale Barzanji
- Diamanti Michael Batistas
- Ariel Batiste
- Jennifer Ann Batra
- Bayada Home Health Care, Inc.
- Farah Bayram
All providers in Sterling, VA · Internal Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.