Individual provider Active NPI

Osman Javed Qaiyum, M.D.

  • Hospitalist Physician
  • Mount Vernon, IL
National Provider Identifier
1851774327
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036.159049 Issued in IL
Practice address
1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone
(708) 369-8223
NPI assigned
Jul 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0093444 MD
Internal Medicine Physician 207R00000X 0101265331 VA
Internal Medicine Physician 207R00000X 036.159049 IL
Internal Medicine Physician 207R00000X 2015021201 MO
Hospitalist Physician 208M00000X 036159049 IL
Hospitalist Physician 208M00000X MD046778 DC
Hospitalist Physician 208M00000X 0101265331 VA
Hospitalist Physician 208M00000X 036.159049 IL Primary

Addresses

Primary practice location

1 Good Samaritan Way
Mount Vernon, IL 62864-2402

Mailing address

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (708) 369-8223

Other practice location 1

2300 Opitz Blvd
Woodbridge, VA 22191-3311
Phone (703) 523-1000

Other practice location 2

727 N Main St
Emporia, VA 23847-1274
Phone (434) 348-4427

Other practice location 3

9401 Lee Hwy Ste 400
Fairfax, VA 22031-1847
Phone (708) 369-8223

Other practice location 4

500 Hospital Dr
Warrenton, VA 20186-3027
Phone (540) 316-5000

Other practice location 5

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156

Other practice location 6

405 W Jackson St
Carbondale, IL 62901-1462
Phone (618) 549-0721

Other practice location 7

201 S 14th St
Herrin, IL 62948-3631
Phone (618) 942-2171

Other practice location 8

100 Fairview Dr
Franklin, VA 23851-1238
Phone (757) 516-1153

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address oqaiyum61452@sih.direct-ci.com
Direct Messaging Address oqaiyum61452@sih.direct-ci.com
Direct Messaging Address oqaiyum61452@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC, MD3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20181203000146 VA Practitioner - HospitalistPractitioner - Internal Medicine 1456657154 Reassigns benefits to 8 organizations
I20190411000305 DC Practitioner - Internal MedicinePractitioner - Hospitalist 1456657154 Reassigns benefits to 5 organizations
I20221114002042 MD Practitioner - HospitalistPractitioner - Internal Medicine 1456657154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Post Acute Telehealth PCGroup PAC ID 9638585391, 63 clinicians

Practice addresses (Care Compare)

6700 Columbia Pike
Annandale, VA 22003-3450
Phone (703) 256-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015021201MOMDInternal Medicine Physician
036.159049ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alexandria Springfield Emergency Physicians PC CurrentSince Dec 18, 2019 Accepting new patients
Hospitalist Medicine Physicians of Virginia LLC Internal Medicine CurrentSince Dec 1, 2018 Accepting new patients
Privia Medical Group, LLC CurrentSince Feb 14, 2019 Accepting new patients
Medical Faculty Associates, Inc Internal Medicine CurrentSince Sep 15, 2019 Accepting new patients
Adfinitas Health at Fauquier, LLC Hospitalist CurrentSince Jun 14, 2020 Accepting new patients
Johns Hopkins Community Physicians, Inc Internal Medicine CurrentSince Feb 17, 2020 Accepting new patients
Inova Health Care Services CurrentSince Nov 1, 2018 Accepting new patients
Ofq, PLLC Internal Medicine CurrentSince May 22, 2022 Accepting new patients
Adfinitas Health at Umcap, LLC Hospitalist CurrentSince Oct 5, 2022 Accepting new patients
Sentara Medical Group Internal Medicine CurrentSince Apr 1, 2020 Accepting new patients
Alexandria Springfield Emergency Physicians PC CurrentSince Dec 18, 2019 Accepting new patients
Southeastern Intensivist Services PC Internal Medicine CurrentSince Mar 11, 2021 Accepting new patients
Privia Medical Group, LLC Internal Medicine CurrentSince Feb 14, 2019 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. Internal Medicine CurrentSince Apr 1, 2019 Accepting new patients
Usacs Integrated Acute Care Services of Maryland, LLC Internal Medicine CurrentSince May 10, 2022 Accepting new patients
Johns Hopkins Community Physicians Internal Medicine CurrentSince Feb 17, 2020 Accepting new patients
Mdics at Anne Arundel LLC Hospitalist CurrentSince Oct 5, 2022 Accepting new patients
Inova Health Care Services Internal Medicine CurrentSince Nov 1, 2018 Accepting new patients
Emergency Medicine Associates P.a., P.C. Internal Medicine CurrentSince Apr 1, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Dimensions Health Corporation Past Accepting new patients

Locations

5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

904 Commerce Rd
Annapolis, MD 21401
Phone (410) 849-6140

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

19801 Observation Dr
Germantown, MD 20876
Phone (301) 557-5928

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

14207 Park Center Dr
Ste 102
Laurel, MD 20707
Phone (301) 604-5254

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

901 Harry S Truman Dr N
Uppr Marlboro, MD 20774
Phone (240) 677-0021

60 E Roslyn Ct
Colonial Hgts, VA 23834
Phone (804) 281-8100

727 N Main St
Emporia, VA 23847
Phone (434) 348-4400

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

200 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 765-5000

500 Hospital Dr
Warrenton, VA 20186
Phone (540) 316-5000

100 Sentara Cir
Ste 2C
Williamsburg, VA 23188
Phone (757) 984-7217

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

2300 Opitz Blvd
Woodbridge, VA 22191
Phone (703) 523-1000

759 S Main St
Woodstock, VA 22664
Phone (540) 459-1100

Interoperability endpoints

  • Direct secure messaging: oqaiyum980286@direct.umm.edu

Organizations & group practices 23

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.

View all 23

Hospital & facility affiliations 1

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": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1851774327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GOOD SAMARITAN WAY",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642402",
            "telephone_number": "708-369-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GOOD SAMARITAN WAY",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642402",
            "telephone_number": "708-369-8223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Opitz Blvd",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221913311",
            "country_code": "US",
            "telephone_number": "703-523-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "727 N Main St",
            "address_purpose": "LOCATION",
            "city": "Emporia",
            "state": "VA",
            "postal_code": "238471274",
            "country_code": "US",
            "telephone_number": "434-348-4427",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9401 Lee Hwy Ste 400",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220311847",
            "country_code": "US",
            "telephone_number": "708-369-8223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Warrenton",
            "state": "VA",
            "postal_code": "201863027",
            "country_code": "US",
            "telephone_number": "540-316-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 S Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663333",
            "country_code": "US",
            "telephone_number": "618-684-3156",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 W Jackson St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011462",
            "country_code": "US",
            "telephone_number": "618-549-0721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483631",
            "country_code": "US",
            "telephone_number": "618-942-2171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Fairview Dr",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "VA",
            "postal_code": "238511238",
            "country_code": "US",
            "telephone_number": "757-516-1153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QAIYUM",
        "first_name": "OSMAN",
        "middle_name": "JAVED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-02",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0093444",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101265331",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.159049",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2015021201",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036159049",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "DC",
            "license": "MD046778",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101265331",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036.159049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oqaiyum61452@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "405 W Jackson St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oqaiyum61452@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "201 S 14th St",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oqaiyum61452@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2 S Hospital Dr",
            "city": "Murphysboro",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629663333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.