Individual provider Active NPI

Deana Ghassan Al-Khateeb, MD

  • Internal Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1851381701
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101226166 Issued in VA
Practice address
2296 Opitz Blvd
Ste 330
Woodbridge, VA 22191-3300
Phone
(703) 670-7600
Fax
(703) 730-5124
NPI assigned
Oct 24, 2005
Last updated
Oct 29, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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 0101226166 VA Primary

Addresses

Primary practice location

2296 Opitz Blvd
Ste 330
Woodbridge, VA 22191-3300

Mailing address

2000 Opitz Blvd
Woodbridge, VA 22191-3306
Phone (703) 499-9144

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050609000381 VA Practitioner - Internal Medicine 7113960295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ridgeview Internal Medicine LLCGroup PAC ID 7416990593, 2 clinicians

Practice addresses (Care Compare)

2000 Opitz Blvd
Woodbridge, VA 22191-3379
Phone (703) 494-4116

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101057815VAMDInternal Medicine Physician
0101226166VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Woodbridge Primary Care PLLC Internal Medicine CurrentSince Apr 26, 2016 Accepting new patients
Ridgeview Internal Medicine Internal Medicine CurrentSince Jul 1, 2005 Accepting new patients
Dominion Medical Center, LLC Internal Medicine Past Accepting new patients
Cardio Vascular Center, LLC Internal Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2000 Opitz Blvd
Woodbridge, VA 22191
Phone (703) 494-4116

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1851381701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 OPITZ BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913306",
            "telephone_number": "703-499-9144",
            "fax_number": "703-730-5124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2296 OPITZ BLVD",
            "address_2": "STE 330",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913300",
            "telephone_number": "703-670-7600",
            "fax_number": "703-730-5124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-KHATEEB",
        "first_name": "DEANA",
        "middle_name": "GHASSAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101226166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.