Individual provider Active NPI

Mohamed H. El Mawan, MD

  • Emergency Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1881644458
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101058502 Issued in VA
Practice address
14904 Jefferson Davis Hwy #204
Woodbridge, VA 20109
Phone
(703) 492-7771
Fax
(703) 492-4442
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101058502 VA Primary

Addresses

Primary practice location

14904 Jefferson Davis Hwy #204
Woodbridge, VA 20109

Mailing address

9755 Thorn Bush Dr
Fairfax Station, VA 22039-2540
Phone (703) 492-7771

Other identifiers 1

IdentifierTypeStateIssuer
005643937MedicaidVA

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
I20041123001078 VA Practitioner - Family Practice 4981669454 Practice locations: Woodbridge, VA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1976
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14904 Jefferson Davis Hwy
Woodbridge, VA 22191-3908
Phone (703) 492-7771

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101058502VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bestpractices, Inc. Emergency Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GHCEAA/Endpoint/GHCEAA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1881644458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9755 THORN BUSH DR",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "220392540",
            "telephone_number": "703-492-7771",
            "fax_number": "703-492-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14904 JEFFERSON DAVIS HWY #204",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "20109",
            "telephone_number": "703-492-7771",
            "fax_number": "703-492-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL MAWAN",
        "first_name": "MOHAMED",
        "middle_name": "H.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101058502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005643937",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.