Individual provider Active NPI

Munira Shodikulova, MD

  • Internal Medicine Physician
  • Sterling, VA
National Provider Identifier
1881080166
Registry record updated Oct 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101264351 Issued in VA
Practice address
20935 Sandian Ter
Sterling, VA 20165-5859
Phone
(571) 234-3290
NPI assigned
Apr 13, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 0101264351 VA Primary

Addresses

Primary practice location

20935 Sandian Ter
Sterling, VA 20165-5859

Mailing address

327 Beach 19TH St
Far Rockaway, NY 11691-4423

Other practice location 1

327 Beach 19th St
Far Rockaway, NY 11691-4423
Phone (718) 869-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, WV2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20180710000793 DC Practitioner - Internal Medicine 8325394125 Reassigns benefits to 2 organizations
I20181115000673 WV Practitioner - Internal Medicine 8325394125 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City Hospital IncGroup PAC ID 3375444524, 155 clinicians

Practice addresses (Care Compare)

2500 Hospital Dr
Martinsburg, WV 25401-3402
Phone (304) 260-1443

Hospital & facility affiliations

  • Berkeley Medical Center Hospital, Martinsburg, WV, CCN 510008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101264351VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of West Virginia- TCG PLLC Single Specialty CurrentSince Oct 15, 2022 Accepting new patients
City Hospital Inc Single Specialty Current Accepting new patients
Fair Oaks Hospitalist Physicians, PLLC Single Specialty CurrentSince Jul 1, 2018 Accepting new patients
Hospitalist Medicine Physicians of West Virginia, PLLC Single Specialty CurrentSince Sep 10, 2018 Accepting new patients
City Hospital, Inc. Internal Medicine CurrentSince Dec 4, 2024 Accepting new patients
City Hospital, Inc Past Accepting new patients

Locations

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

2500 Hospital Dr
Martinsburg, WV 25401
Phone (304) 233-4134

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

Organizations & group practices 7

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 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": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539993600000",
    "number": "1881080166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 BEACH 19TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20935 SANDIAN TER",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201655859",
            "telephone_number": "571-234-3290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "327 Beach 19th St",
            "address_purpose": "LOCATION",
            "city": "Far Rockaway",
            "state": "NY",
            "postal_code": "116914423",
            "country_code": "US",
            "telephone_number": "718-869-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHODIKULOVA",
        "first_name": "MUNIRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2018-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101264351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

Verify at the official NPI Registry.