Ageless M.D., LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

0101232169 Issued in VA

Legal business name

AGELESS M.D., LLC

Practice address

2221 N Buchanan St
Arlington, VA 22207-2526

Phone

(703) 688-2468

Fax

(703) 859-7689

NPI assigned

Aug 8, 2012

Last updated

Oct 10, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Shai Seyedan

Title

Partner

Phone

(703) 688-2468

Specialties & licenses 3

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rajesh Puri, M.D., FAAP, FACPH

  • General Practice Physician
  • Arlington, VA
  • NPI 1194939033
  NPD (past)
• Derron M Simon, MD

  • Surgery Physician
  • Arlington, VA
  • NPI 1164482980
  NPD (past)

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444435200000",
    "number": "1902153992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 N BUCHANAN ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222072526",
            "telephone_number": "703-688-2468",
            "fax_number": "703-859-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 N BUCHANAN ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222072526",
            "telephone_number": "703-688-2468",
            "fax_number": "703-859-7689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-08",
        "last_updated": "2015-10-10",
        "status": "A",
        "authorized_official_last_name": "SEYEDAN",
        "authorized_official_first_name": "SHAI",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "703-688-2468",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "VA",
            "license": "0101232169",
            "primary": true
        },
        {
            "code": "261QC1800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Corporate Health",
            "state": "VA",
            "license": "0101232169",
            "primary": false
        },
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "VA",
            "license": "0101232169",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advent Health Group, P.C.
• Parviz Afiatpour, RPH
• Andrea Elizabeth Africa, PTA
• Agape Dental Studio LLC
• Renee Bobbie Jaeger Agee, LCSW
• Karina Aguilar
• Karla Aguirre
• Brian Agyeman, PHARM.D.
• Seher Ahmad, FNP-BC
• Mushfique Ahmed, MD

• Clinic/Center in Arlington, VA
• Providers in Arlington, VA by specialty
• Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.