Individual provider Active NPI

Abdul Rahman Qani, PA-C

  • Surgical Physician Assistant
  • Fredericksburg, VA
National Provider Identifier
1801318654
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
10 Stafford Lakes Pkwy Ste 102
Fredericksburg, VA 22406-7305
Phone
(540) 741-6982
NPI assigned
Jul 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

10 Stafford Lakes Pkwy Ste 102
Fredericksburg, VA 22406-7305

Mailing address

15 Springbrook Way
Portland, ME 04103-1056
Phone (207) 409-3495

Other practice location 1

100 Brickhill Ave
South Portland, ME 04106-1999
Phone (207) 773-1728

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221007000718 VA Practitioner - Physician Assistant 7113291907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
MWHC Urgent Care LLCGroup PAC ID 8921338427, 20 clinicians

Practice addresses (Care Compare)

11131 Journal Pkwy
Suite a
King George, VA 22485-3468
Phone (540) 709-5173

4900 Plank Rd
Suite 101
Fredericksburg, VA 22407-6626
Phone (540) 741-0679

955 Wonder Rd
Suite C
Stafford, VA 22554-7798
Phone (540) 741-7890

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Woodbridge Home Healthcare LLC Current Accepting new patients
MWHC Urgent Care LLC CurrentSince Sep 1, 2022 Accepting new patients

Locations

10 Stafford Lakes Pkwy
Ste 102
Fredericksburg, VA 22406
Phone (540) 737-6144

11131 Journal Pkwy
Ste A
King George, VA 22485
Phone (540) 709-5173

Interoperability endpoints

  • Direct secure messaging: aqani179534@direct.mmc.mainehealth.org
  • Direct secure messaging: aqani97323@marywashingtonhealthcare.direct-ci.com

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": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1801318654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SPRINGBROOK WAY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031056",
            "telephone_number": "207-409-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 STAFFORD LAKES PKWY STE 102",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224067305",
            "telephone_number": "540-741-6982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Brickhill Ave",
            "address_purpose": "LOCATION",
            "city": "South Portland",
            "state": "ME",
            "postal_code": "041061999",
            "country_code": "US",
            "telephone_number": "207-773-1728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QANI",
        "first_name": "ABDUL",
        "middle_name": "RAHMAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-13",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.