Active NPI
New Life Medical LLC
- Critical Care Medicine (Internal Medicine) Physician
- Woodbridge, VA
National Provider Identifier
1811463086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician
- Legal business name
- NEW LIFE MEDICAL LLC
- Practice address
- 2300 Opitz Blvd
Woodbridge, VA 22191-3311 - Phone
- (703) 523-1000
- NPI assigned
- Oct 16, 2018
- Last updated
- Oct 16, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nebiyu Biru, MD
- Title
- Critical Care Medicine
- Phone
- (732) 939-7248
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | NU | Primary |
Addresses
Primary practice location
2300 Opitz Blvd
Woodbridge, VA 22191-3311
Mailing address
3025 Nassau Dr
Brookfield, WI 53045-3454
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
2300 Opitz Blvd
Ste 1258
Woodbridge, VA 22191
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539648000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1539648000000",
"number": "1811463086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3025 NASSAU DR",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530453454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 OPITZ BLVD",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221913311",
"telephone_number": "703-523-1000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEW LIFE MEDICAL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-16",
"last_updated": "2018-10-16",
"status": "A",
"authorized_official_last_name": "BIRU",
"authorized_official_first_name": "NEBIYU",
"authorized_official_title_or_position": "CRITICAL CARE MEDICINE",
"authorized_official_telephone_number": "732-939-7248",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.