Individual provider Active NPI

Mehrdad Ebadi-Tehrani, MD

  • Hematology & Oncology Physician
  • Alexandria, VA
National Provider Identifier
1730162967
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
0101053922 Issued in VA
Practice address
5226 Dawes Ave
Alexandria, VA 22311-1404
Phone
(703) 379-9111
Fax
(703) 931-7952
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 0101053922 VA Primary

Addresses

Primary practice location

5226 Dawes Ave
Alexandria, VA 22311-1404

Mailing address

5226 Dawes Ave
Alexandria, VA 22311-1404
Phone (703) 379-9111

Other identifiers 8

IdentifierTypeStateIssuer
0005OtherBS DC
216687OtherBS VA
271769OtherALLIANCE
281214OtherAMERIGROUP
37380005OtherCAPITAL CARE
3738OtherBS DC GROUP
271769OtherMDJPA
2220548OtherUS HEALTH CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101053922VAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hematology Oncology Assoc LTD Hematology & Oncology Past Accepting new patients

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204848000000",
    "number": "1730162967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5226 DAWES AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111404",
            "telephone_number": "703-379-9111",
            "fax_number": "703-931-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5226 DAWES AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111404",
            "telephone_number": "703-379-9111",
            "fax_number": "703-931-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBADI-TEHRANI",
        "first_name": "MEHRDAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2008-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "VA",
            "license": "0101053922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS DC",
            "identifier": "0005",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS VA",
            "identifier": "216687",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE",
            "identifier": "271769",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "281214",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL CARE",
            "identifier": "37380005",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS DC GROUP",
            "identifier": "3738",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDJPA",
            "identifier": "271769",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US HEALTH CARE",
            "identifier": "2220548",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.