Individual provider Active NPI

Nima Marcus Bushehri, DO

  • Physical Medicine & Rehabilitation Physician
  • Fort Belvoir, VA
National Provider Identifier
1851561294
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0102202678 Issued in VA
Practice address
5980 9TH Street
Intrepid Spirit Center
Fort Belvoir, VA 22060
Phone
(571) 231-1210
Fax
(571) 231-8808
NPI assigned
Feb 29, 2008
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X H0071194 MD
Physical Medicine & Rehabilitation Physician 208100000X DO.000152 LA
Physical Medicine & Rehabilitation Physician 208100000X 0102202678 VA Primary

Addresses

Primary practice location

5980 9TH Street
Intrepid Spirit Center
Fort Belvoir, VA 22060

Mailing address

1021 N Garfield St Apt 615
Arlington, VA 22201-2576
Phone (703) 328-2246

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
I20110425000107 DC Practitioner - Physical Medicine and Rehabilitation 5890970529 Practice locations: Washington, DC

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO.000152LAMDPhysical Medicine & Rehabilitation Physician
H0071194MDMDPhysical Medicine & Rehabilitation Physician
0102202678VAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hassan Bushehri, M.D., P.C. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1851561294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N GARFIELD ST APT 615",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222012576",
            "telephone_number": "703-328-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5980 9TH STREET",
            "address_2": "INTREPID SPIRIT CENTER",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "22060",
            "telephone_number": "571-231-1210",
            "fax_number": "571-231-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHEHRI",
        "first_name": "NIMA",
        "middle_name": "MARCUS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-29",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "H0071194",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "LA",
            "license": "DO.000152",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0102202678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Belvoir, VA

Sources for this page

Verify at the official NPI Registry.