Individual provider Active NPI

Nowal Al Baqui, MD

  • Nephrology Physician
  • Fairfax, VA
National Provider Identifier
1639432198
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
0101258454 Issued in VA
Practice address
13135 Lee Jackson Memorial Hwy
#135
Fairfax, VA 22033-1907
Phone
(703) 961-0488
Fax
(703) 961-0480
NPI assigned
Jun 20, 2012
Last updated
Aug 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 0101258454 VA Primary

Addresses

Primary practice location

13135 Lee Jackson Memorial Hwy
#135
Fairfax, VA 22033-1907

Mailing address

13135 Lee Jackson Mem Hwy
Suite 135
Fairfax, VA 22033-1907
Phone (703) 961-0484

Other identifiers 1

IdentifierTypeStateIssuer
1639432198MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150903002372 DC Practitioner - Internal MedicinePractitioner - Nephrology 9739495813 Reassigns benefits to 1 organization
I20150921000355 VA Practitioner - Internal MedicinePractitioner - Nephrology 9739495813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Washington Healthcare Providers LLCGroup PAC ID 1456629369, 264 clinicians

Practice addresses (Care Compare)

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-4350

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fair Oaks Hospitalist Physicians, PLLC CurrentSince May 1, 2018 Accepting new patients
Mary Washington Healthcare Providers LLC CurrentSince Jul 1, 2018 Accepting new patients

Locations

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

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

125 Hospital Center Blvd
Stafford, VA 22554
Phone (540) 602-6500

Interoperability endpoints

  • Direct secure messaging: nalbaqui54464@marywashingtonhealthcare.direct-ci.com
  • Direct secure messaging: nowalalbaqui@nanv.allscriptsdirect.net

Organizations & group practices 2

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 4

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1639432198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13135 LEE JACKSON MEM HWY",
            "address_2": "SUITE 135",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331907",
            "telephone_number": "703-961-0484",
            "fax_number": "703-961-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13135 LEE JACKSON MEMORIAL HWY",
            "address_2": "#135",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331907",
            "telephone_number": "703-961-0488",
            "fax_number": "703-961-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL BAQUI",
        "first_name": "NOWAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "VA",
            "license": "0101258454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639432198",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.