Individual provider Active NPI

Mehran Bajoghli, M.D.

  • General Practice Physician
  • McLean, VA
National Provider Identifier
1699868786
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0101231597 Issued in VA
Practice address
1570 Onyx Dr Unit 305
MC Lean, VA 22102-3957
Phone
(703) 244-9117
Fax
(571) 200-2618
NPI assigned
Oct 2, 2006
Last updated
May 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X 07395 VA
Addiction Medicine (Internal Medicine) Physician 207RA0401X 0101231597 VA
General Practice Physician 208D00000X 0101231597 VA Primary

Addresses

Primary practice location

1570 Onyx Dr Unit 305
MC Lean, VA 22102-3957

Mailing address

1570 Onyx Dr Unit 305
MC Lean, VA 22102-3957
Phone (703) 244-9117

Other identifiers 2

IdentifierTypeStateIssuer
30016041500017MedicaidVA
6B8333OtherMEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200214001352 VA Practitioner - Family Practice 5698749737 Reassigns benefits to 1 organization
I20231117000827 DC Practitioner - General PracticePractitioner - Addiction Medicine 5698749737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Addiction Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1570 Onyx Dr
Unit 305
MC Lean, VA 22102-3957
Phone (703) 244-9117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
07395VAMDNuclear Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allevius Clinic Addiction Medicine CurrentSince Jul 25, 2023 Accepting new patients
Recover Together, Inc. Internal Medicine CurrentSince Sep 1, 2023 Accepting new patients
Brightview LLC Addiction Medicine CurrentSince Apr 19, 2022 Accepting new patients
Recover Together, LLC Internal Medicine CurrentSince Sep 1, 2023 Accepting new patients
Brightview LLC Addiction Medicine CurrentSince Apr 19, 2022 Accepting new patients
Wynn Medical Center Past Accepting new patients
Crossroads Treatment Center of Winchester, PC PastSince Dec 1, 2019 Accepting new patients

Locations

Dept CH 17590
Palatine, IL 60055
Phone (844) 450-3100

615 Elsinore Pl
Ste 200
Cincinnati, OH 45202
Phone (513) 639-2800

240 Executive Center Pkwy
Fredericksburg, VA 22401
Phone (540) 371-1700

3704 Old Forest Rd
Lynchburg, VA 24501

8551 Rixlew Ln
Ste 100
Manassas, VA 20109
Phone (540) 212-6090

6212 Jefferson Ave
Newport News, VA 23605

310 Turner Rd
Ste Dh
North Chesterfield, VA 23225
Phone (540) 202-2554

280 Virginia Ave NE
Ste 104
Norton, VA 24273
Phone (276) 679-0321

4899 Prince William Pkwy
Woodbridge, VA 22192

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: mehran.bajoghli@202362935902212.direct.elationemr.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1699868786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 ONYX DR UNIT 305",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023957",
            "telephone_number": "703-244-9117",
            "fax_number": "571-200-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 ONYX DR UNIT 305",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023957",
            "telephone_number": "703-244-9117",
            "fax_number": "571-200-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJOGHLI",
        "first_name": "MEHRAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "VA",
            "license": "07395",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "VA",
            "license": "0101231597",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101231597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30016041500017",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "6B8333",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

Verify at the official NPI Registry.