Individual provider Active NPI

Firoozeh Hosseini Shahidi, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Falls Church, VA
National Provider Identifier
1619058674
Registry record updated Jul 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
0101047063 Issued in VA
Practice address
313 Park Ave
Suite 202
Falls Church, VA 22046
Phone
(703) 533-3010
Fax
(703) 538-4316
NPI assigned
Oct 18, 2006
Last updated
Jul 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 0101047063 VA Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X D0039885 MD
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD19613 DC

Addresses

Primary practice location

313 Park Ave
Suite 202
Falls Church, VA 22046

Mailing address

313 Park Ave
Suite 202
Falls Church, VA 22046
Phone (703) 533-3010

Other identifiers 1

IdentifierTypeStateIssuer
6006892MedicaidVA

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
I20101109000460 DC Practitioner - EndocrinologyPractitioner - Internal Medicine 7113112798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

313 Park Ave
Suite 202
Falls Church, VA 22046-3303
Phone (703) 533-3506

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19613DCMDEndocrinology, Diabetes & Metabolism Physician
D0039885MDMDEndocrinology, Diabetes & Metabolism Physician
0101047063VAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Avenue Medical Group, P.C. Endocrinology, Diabetes & Metabolism CurrentSince Nov 8, 1990 Accepting new patients

Locations

313 Park Ave
Ste 202
Falls Church, VA 22046
Phone (703) 497-0212

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278979200000",
    "number": "1619058674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 PARK AVE",
            "address_2": "SUITE 202",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22046",
            "telephone_number": "703-533-3010",
            "fax_number": "703-538-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 PARK AVE",
            "address_2": "SUITE 202",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22046",
            "telephone_number": "703-533-3010",
            "fax_number": "703-538-4316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHIDI",
        "first_name": "FIROOZEH",
        "middle_name": "HOSSEINI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2010-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VA",
            "license": "0101047063",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MD",
            "license": "D0039885",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "DC",
            "license": "MD19613",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006892",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.