Individual provider Active NPI

Khaled M Sebawih Abdalla, MD

  • Neurology Physician
  • Charlottesville, VA
National Provider Identifier
1750811428
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
0101272773 Issued in VA
Practice address
1215 Lee St
Charlottesville, VA 22908-0816
Phone
(434) 924-2101
Fax
(434) 982-2580
NPI assigned
Jun 15, 2017
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MT213344 PA
Neurology Physician 2084N0400X 0101272773 VA Primary

Addresses

Primary practice location

1215 Lee St
Charlottesville, VA 22908-0816

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Other practice location 1

1221 Lee St,
Charlottesville, VA 22903
Phone (434) 924-2706

Other practice location 2

125A Medical Cir
Winchester, VA 22601-3322
Phone (540) 667-1828

Other practice location 3

1840 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-8000

Other practice location 4

1830 Amherst St
Winchester, VA 22601-2808
Phone (540) 667-1828

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address kabdalla1157438@soc.inova.org
Direct Messaging Address kabdalla1157438@soc.inova.org
Direct Messaging Address kabdalla1157438@soc.inova.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20220131000473 VA Practitioner - Neurology 5890188601 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Physician Enterprise IncGroup PAC ID 9931268091, 176 clinicians
Winchester Medical CenterGroup PAC ID 0244134021, 313 clinicians

Practice addresses (Care Compare)

125 Medical Cir
Suite a
Winchester, VA 22601-3322
Phone (540) 667-1828

1840 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-8700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT213344PAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Medical Center CurrentSince Aug 28, 2023 Accepting new patients
University of Virginia Physicians Group CurrentSince Sep 29, 2021 Accepting new patients
Valley Physician Enterprise, Inc. Neurology CurrentSince Aug 28, 2023 Accepting new patients
Valley Physician Enterprise, Inc. CurrentSince Aug 28, 2023 Accepting new patients
Shenandoah Valley Pathology Laboratories Inc Current Accepting new patients
Valley Physician Enterprise, Inc Neurology Current Accepting new patients
Winchester Medical Center Current Accepting new patients
Winchester Medical Center Neurology CurrentSince Aug 28, 2023 Accepting new patients
Winchester Medical Center Current Accepting new patients
Rector & Visitors of the University of Virginia PastSince Aug 1, 2021 Accepting new patients

Locations

1215 Lee St
Fl 1
Charlottesville, VA 22908
Phone (434) 924-9400

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1000 N Shenandoah Ave
Front Royal, VA 22630
Phone (540) 636-0300

125 Medical Cir
#A
Winchester, VA 22601
Phone (540) 667-1828

125A Medical Cir
Winchester, VA 22601
Phone (540) 450-0072

1830 Amherst St
Winchester, VA 22601
Phone (540) 536-0057

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

Interoperability endpoints

  • Direct secure messaging: kabdalla1155527@valleyhealth.direct-ci.com

Organizations & group practices 10

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 6

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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1750811428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-2101",
            "fax_number": "434-982-2580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 Lee St,",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "22903",
            "country_code": "US",
            "telephone_number": "434-924-2706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125A Medical Cir",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226013322",
            "country_code": "US",
            "telephone_number": "540-667-1828",
            "fax_number": "540-722-6207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1840 Amherst St",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012808",
            "country_code": "US",
            "telephone_number": "540-536-8000",
            "fax_number": "540-536-7780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1830 Amherst St",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012808",
            "country_code": "US",
            "telephone_number": "540-667-1828",
            "fax_number": "540-722-6207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDALLA",
        "first_name": "KHALED",
        "middle_name": "M SEBAWIH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-15",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MT213344",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101272773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kabdalla1157438@soc.inova.org",
            "affiliation": "N",
            "address_1": "125A Medical Cir",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226013322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kabdalla1157438@soc.inova.org",
            "affiliation": "N",
            "address_1": "1830 Amherst St",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kabdalla1157438@soc.inova.org",
            "affiliation": "N",
            "address_1": "1840 Amherst St",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.