Individual provider Active NPI

Mohamad Haroon Nazari, PA

  • Medical Physician Assistant
  • Woodbridge, VA
National Provider Identifier
1881331510
Registry record updated May 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
2300 Opitz Blvd
Woodbridge, VA 22191-3311
Phone
(517) 775-8982
NPI assigned
May 15, 2022
Last updated
May 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

2300 Opitz Blvd
Woodbridge, VA 22191-3311

Mailing address

12623 Jedburg LN
Woodbridge, VA 22192-5020
Phone (517) 775-8982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MD, DC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220713001426 VA Practitioner - Physician Assistant 3870974538 Reassigns benefits to 4 organizations
I20230309001910 MD Practitioner - Physician Assistant 3870974538 Reassigns benefits to 1 organization
I20230309001977 DC Practitioner - Physician Assistant 3870974538 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Alliance Medical Team LLCGroup PAC ID 9133652852, 16 clinicians
Alliance Medical GroupGroup PAC ID 0941615322, 5 clinicians

Practice addresses (Care Compare)

14906 Richmond Hwy
Woodbridge, VA 22191-4016
Phone (609) 335-6595

2300 Opitz Blvd
Woodbridge, VA 22191-3311
Phone (571) 530-5951

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
M Medical Group, Inc. CurrentSince Feb 24, 2023 Accepting new patients
M Medical Group, Inc. CurrentSince Feb 24, 2023 Accepting new patients
M Medical Group, Inc. CurrentSince Feb 24, 2023 Accepting new patients

Locations

22 S Athol Ave
Baltimore, MD 21229
Phone (410) 566-5015

9106 Pine View Ln
Clinton, MD 20735
Phone (301) 856-2930

1 Price Dr
Elkton, MD 21921
Phone (410) 398-6474

1051 Brightseat Rd
Landover, MD 20785
Phone (240) 487-4400

1004 Independence Blvd
Virginia Beach, VA 23455
Phone (757) 464-4058

14906 Richmond Hwy
Woodbridge, VA 22191
Phone (609) 335-6595

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1652572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652572800000",
    "number": "1881331510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12623 JEDBURG LN",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925020",
            "telephone_number": "517-775-8982"
        },
        {
            "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": "517-775-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARI",
        "first_name": "MOHAMAD",
        "middle_name": "HAROON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-15",
        "last_updated": "2022-05-15",
        "certification_date": "2022-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.