Individual provider Active NPI

Mandana Hashefi, MD

  • Rheumatology Physician
  • Morgantown, WV
National Provider Identifier
1790740918
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
28564 Issued in WV
Practice address
600 Suncrest Town Centre Dr
Morgantown, WV 26505-0589
Phone
(304) 598-4478
NPI assigned
Apr 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 28564 WV Primary

Addresses

Primary practice location

600 Suncrest Town Centre Dr
Morgantown, WV 26505-0589

Mailing address

600 Suncrest Town Centre Dr
Morgantown, WV 26505-0589
Phone (304) 598-4478

Other identifiers 1

IdentifierTypeStateIssuer
035710700MedicaidDC

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
I20040708001275 DC Practitioner - Rheumatology 4688652472 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28564WVMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Oct 13, 2018 Accepting new patients
Privia Medical Group, LLC CurrentSince Oct 13, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1790740918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SUNCREST TOWN CENTRE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265050589",
            "telephone_number": "304-598-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SUNCREST TOWN CENTRE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265050589",
            "telephone_number": "304-598-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASHEFI",
        "first_name": "MANDANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WV",
            "license": "28564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035710700",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.