Organization Active NPI

Marjan Yousefi, M.D., P.C.

  • Dermatology Physician
  • Vienna, VA
National Provider Identifier
1619113388
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101243049 Issued in VA
Legal business name
MARJAN YOUSEFI, M.D., P.C.
Practice address
8100 Boone Blvd
Suite 250
Vienna, VA 22182-2665
Phone
(703) 255-5070
Fax
(703) 525-5802
NPI assigned
Dec 30, 2008
Last updated
Sep 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Authorized official

Name
Dr. Marjan Yousefi, M.D.NPI 1770742249
Title
President
Phone
(703) 255-5070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0101243049 VA Primary

Addresses

Primary practice location

8100 Boone Blvd
Suite 250
Vienna, VA 22182-2665

Mailing address

8100 Boone Blvd
Suite 250
Vienna, VA 22182-2665
Phone (703) 255-5070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090112000740 DC Part B Supplier - Clinic/Group Practice 2365505708 Receives reassigned benefits from 3 practitioners
Practice locations: Arlington, VA; Vienna, VA

National Provider Directory

National Provider Directory

Locations

2300 N Pershing Dr
Ste 204
Arlington, VA 22201
Phone (703) 255-5070

502 Maple Ave W
Vienna, VA 22180
Phone (703) 255-4922

8230 Boone Blvd
Ste 430
Vienna, VA 22182
Phone (202) 361-7871

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1230595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317081600000",
    "number": "1619113388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 BOONE BLVD",
            "address_2": "SUITE 250",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822665",
            "telephone_number": "703-255-5070",
            "fax_number": "703-525-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 BOONE BLVD",
            "address_2": "SUITE 250",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822665",
            "telephone_number": "703-255-5070",
            "fax_number": "703-525-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARJAN YOUSEFI, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-30",
        "last_updated": "2011-09-27",
        "status": "A",
        "authorized_official_last_name": "YOUSEFI",
        "authorized_official_first_name": "MARJAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-255-5070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101243049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.