Individual provider Active NPI

Tajammul Ehsan, MD

  • Neurology Physician
  • Herndon, VA
National Provider Identifier
1760583397
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
0101232388 Issued in VA
Practice address
722 Grant St
Ste. F
Herndon, VA 20170-4532
Phone
(703) 787-7638
Fax
(703) 787-7654
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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 0101232388 VA Primary
Clinical Neurophysiology Physician 2084N0600X 0101232388 VA

Addresses

Primary practice location

722 Grant St
Ste. F
Herndon, VA 20170-4532

Mailing address

722 Grant St
Ste. F
Herndon, VA 20170-4532
Phone (703) 787-7638

Other identifiers 1

IdentifierTypeStateIssuer
7117787MedicaidVA

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
I20120524000103 DC Practitioner - Neurology 0446413165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

722 Grant St
Suite F
Herndon, VA 20170-4533
Phone (703) 376-8613

Hospital & facility affiliations

  • Inova Fair Oaks Hospital Hospital, Fairfax, VA, CCN 490101
  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

Merit-based Incentive Payment System (MIPS)

Final score
87.05 of 100Reported as individual
Quality
63.53
Improvement activities
40
Cost
92.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101232388VAMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Shabih Hasan MD PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tajammul.ehsan.1@3868.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/3869/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1760583397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 GRANT ST",
            "address_2": "STE. F",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704532",
            "telephone_number": "703-787-7638",
            "fax_number": "703-787-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 GRANT ST",
            "address_2": "STE. F",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704532",
            "telephone_number": "703-787-7638",
            "fax_number": "703-787-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHSAN",
        "first_name": "TAJAMMUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101232388",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "VA",
            "license": "0101232388",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7117787",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

Verify at the official NPI Registry.