Individual provider Active NPI

Mina Fazli, MD

  • Internal Medicine Physician
  • Rockville, MD
National Provider Identifier
1801966569
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0064871 Issued in MD
Practice address
6121 Montrose Rd
Rockville, MD 20852-4803
Phone
(301) 770-8377
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0064871 MD Primary

Addresses

Primary practice location

6121 Montrose Rd
Rockville, MD 20852-4803

Mailing address

6121 Montrose Rd
Rockville, MD 20852-4803
Phone (301) 770-8377

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
I20070529000211 DC Practitioner - Internal Medicine 1254438153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hebrew Home of Greater Washington IncGroup PAC ID 2264324060, 4 clinicians

Practice addresses (Care Compare)

6121 Montrose Rd
Rockville, MD 20852-4803
Phone (301) 816-8377

Hospital & facility affiliations

  • Jewish Social Service Agency Hospice Hospice, Rockville, MD, CCN 211508
  • Montgomery Hospice & Prince Georges Hospice Hospice, Rockville, MD, CCN 211503
  • Hebrew Home of Greater Washington Nursing home, Rockville, MD, CCN 215071

Merit-based Incentive Payment System (MIPS)

Final score
25.9 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
86.33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0064871MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hebrew Home of Greater Washington Inc CurrentSince May 7, 2009 Accepting new patients
Hebrew Home of Greater Washington Inc CurrentSince May 7, 2009 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Hebrew Home of Greater Washington Past Accepting new patients

Locations

6121 Montrose Rd
Rockville, MD 20852
Phone (301) 770-8377

Organizations & group practices 4

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 2

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1801966569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 MONTROSE RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524803",
            "telephone_number": "301-770-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 MONTROSE RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524803",
            "telephone_number": "301-770-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZLI",
        "first_name": "MINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0064871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.