Individual provider Active NPI

Mehdi Bajoghli, M.D.

  • Specialist
  • Woodbridge, VA
National Provider Identifier
1720193048
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
2200 Opitz Blvd
Suite 230
Woodbridge, VA 22191-3321
Phone
(703) 490-5803
Fax
(703) 490-6443
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X VA Primary

Addresses

Primary practice location

2200 Opitz Blvd
Suite 230
Woodbridge, VA 22191-3321

Mailing address

2200 Opitz Blvd
Suite 230
Woodbridge, VA 22191-3321
Phone (703) 490-5803

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
I20051005000438 DC Practitioner - Allergy/Immunology 0446237986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1957
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin and Laser Surgery CenterGroup PAC ID 4082788302, 8 clinicians

Practice addresses (Care Compare)

1359 Beverly Rd
Suite 200
MC Lean, VA 22101-3668
Phone (703) 893-1114

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Skin and Laser Surgery Center CurrentSince May 7, 2020 Accepting new patients

Locations

1359 Beverly Rd
Ste 200
McLean, VA 22101
Phone (703) 893-1114

2200 Opitz Blvd
Ste 230
Woodbridge, VA 22191
Phone (703) 490-5803

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720193048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 OPITZ BLVD",
            "address_2": "SUITE 230",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913321",
            "telephone_number": "703-490-5803",
            "fax_number": "703-490-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 OPITZ BLVD",
            "address_2": "SUITE 230",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913321",
            "telephone_number": "703-490-5803",
            "fax_number": "703-490-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJOGHLI",
        "first_name": "MEHDI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.