Syed Khurram Mahboob, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101241509 Issued in VA

Practice address

4379 Ridgewood Center Dr
Suite 102
Woodbridge, VA 22192-8322

Phone

(703) 680-7950

Fax

(703) 680-7953

NPI assigned

Jan 29, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 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

Specialty

Family Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greater Prince William Area Community Health Center IncGroup PAC ID 9436258209, shared by 4 NPIs, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uva Health Prince William Medical Center Hospital, Manassas, VA, CCN 490045

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Greater Prince William Area Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Woodbridge, VA
  • NPI 1366591562
  Medicare reassignment NPD
• Mdics Rehabilitative Services LLC

  • Internal Medicine Physician
  • Glen Burnie, MD
  • NPI 1124313309

  DC, Family Medicine

  Medicare reassignment NPD
• Greater Prince William Area Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Manassas, VA
  • NPI 1750263422
  NPD
• Greater Prince William Area Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Manassas, VA
  • NPI 1770914939
  NPD
• Mdics at Civista LLC

  • Hospitalist Physician
  • La Plata, MD
  • NPI 1225323496
  NPD
• Maryland Inpatient Care Specialists LLC

  • Internal Medicine Physician
  • Annapolis, MD
  • NPI 1255417200
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Uva Prince William Medical Center

  • General Acute Care Hospital
  • Manassas, VA
  • NPI 1417005760
  Care Compare affiliation

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1770760944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4379 RIDGEWOOD CENTER DR STE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928323",
            "telephone_number": "703-680-7950",
            "fax_number": "703-680-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4379 RIDGEWOOD CENTER DR",
            "address_2": "SUITE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928322",
            "telephone_number": "703-680-7950",
            "fax_number": "703-680-7953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23501 Cinco Ranch Blvd Ste G205",
            "address_purpose": "LOCATION",
            "city": "Katy",
            "state": "TX",
            "postal_code": "774943286",
            "country_code": "US",
            "telephone_number": "346-271-9655",
            "fax_number": "346-273-1825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14100 Southwest Fwy Ste 400",
            "address_purpose": "LOCATION",
            "city": "Sugar Land",
            "state": "TX",
            "postal_code": "774783465",
            "country_code": "US",
            "telephone_number": "281-972-4972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHBOOB",
        "first_name": "SYED",
        "middle_name": "KHURRAM",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-29",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V2156",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "V2156",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D70693",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101241509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ingrid Madison, LGSW
• Magnus Heart and Vascular, Inc.
• Laura Mahabir
• Kathleen Kearney Mahar, PH. D., LCSW
• Yasir Mahboba
• Desiree Debora Mahmoud
• Hien Thanh Mai, PHARMD
• Marion Anne Nyawira Maina
• Rita Theresa Maise I, LCSW
• Makeyshia Kimyatta Major, LCSW

• Family Medicine Physician in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.