Individual provider Active NPI

Bahareh Nazemi, FNP

  • Family Nurse Practitioner
  • Leesburg, VA
National Provider Identifier
1629628698
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024177826 Issued in VA
Practice address
44045 Riverside Pkwy
Leesburg, VA 20176-5101
Phone
(703) 858-6202
Fax
(703) 858-6230
NPI assigned
Sep 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 0024177826 VA Primary

Addresses

Primary practice location

44045 Riverside Pkwy
Leesburg, VA 20176-5101

Mailing address

20821 Apollo Ter
Ashburn, VA 20147-2826
Phone (703) 403-6239

Other practice location 1

19490 Sandridge Way Ste 240
Lansdowne, VA 20176-3467
Phone (571) 223-5723

Other practice location 2

2501 Parkers Ln
Alexandria, VA 22306-3209
Phone (703) 664-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200622001620 VA Practitioner - Nurse Practitioner 1951723998 Reassigns benefits to 2 organizations
I20200925000692 DC Practitioner - Nurse Practitioner 1951723998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 771-2960

Hospital & facility affiliations

  • Inova Loudoun Hospital Hospital, Leesburg, VA, CCN 490043
  • Inova Fair Oaks Hospital Hospital, Fairfax, VA, CCN 490101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024177826VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services Single Specialty Current Accepting new patients
Privia Medical Group, LLC CurrentSince May 18, 2020 Accepting new patients
Inova Health Care Services Single Specialty CurrentSince Mar 1, 2020 Accepting new patients
Privia Medical Group, LLC Single Specialty CurrentSince May 18, 2020 Accepting new patients
Inova Health Care Services Single Specialty CurrentSince Mar 1, 2020 Accepting new patients

Locations

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

44055 Riverside Pkwy
Ste 106
Leesburg, VA 20176
Phone (703) 858-6202

8644 Sudley Rd
#220
Manassas, VA 20110

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1629628698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20821 APOLLO TER",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201472826",
            "telephone_number": "703-403-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44045 RIVERSIDE PKWY",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201765101",
            "telephone_number": "703-858-6202",
            "fax_number": "703-858-6230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19490 Sandridge Way Ste 240",
            "address_purpose": "LOCATION",
            "city": "Lansdowne",
            "state": "VA",
            "postal_code": "201763467",
            "country_code": "US",
            "telephone_number": "571-223-5723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2501 Parkers Ln",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223063209",
            "country_code": "US",
            "telephone_number": "703-664-7000",
            "fax_number": "703-664-7666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAZEMI",
        "first_name": "BAHAREH",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024177826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.