Andrew Keith Mazur, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305205338 Issued in VA

Practice address

24430 Stone Springs Blvd Ste 400
Dulles, VA 20166-2268

Phone

(703) 776-5040

Fax

(703) 776-5047

NPI assigned

Aug 26, 2005

Last updated

Jan 9, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairfax Family Practice Centers PCGroup PAC ID 4082513031, 106 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fairfax Family Practice Centers PC

  • Family Medicine Physician
  • Herndon, VA
  • NPI 1205944964
  Medicare reassignment Care Compare group NPD
• Inova Physician Partners, LLC

  • Family Medicine Physician
  • Chantilly, VA
  • NPI 1215264916

  DC

  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC

  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Inova Physician Partners, Inc. - Specialists

  • Orthopaedic Surgery Physician
  • Leesburg, VA
  • NPI 1811204050
  NPD (past)

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1902899719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37189",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973189",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24430 STONE SPRINGS BLVD STE 400",
            "city": "DULLES",
            "state": "VA",
            "postal_code": "201662268",
            "telephone_number": "703-776-5040",
            "fax_number": "703-776-5047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46440 Benedict Dr",
            "address_2": "Suite 107",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201646602",
            "country_code": "US",
            "telephone_number": "703-450-1125",
            "fax_number": "703-450-1145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZUR",
        "first_name": "ANDREW",
        "middle_name": "KEITH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "2502",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305205338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902899719",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amazur711875@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Exchange Information",
            "affiliationName": "Inova Physician Partners, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "115 Park St SE # 205300",
            "city": "Vienna",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221804653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Luxottica of America Inc. (Sears Optical #1102)
• Morgan Maddox, FNP-C
• David Michael Mahan, PA
• Lana Adil Mahgoub, PHD, LP
• Kisha Levinita Marquez, MASSAGE THERAPIST
• Mdics at Stonesprings, LLC
• Daniel Lee Meikle, M.D.
• Mobile Medical Health
• Richard Joseph Morris, M.D.
• Caitlyn Mulcahy, NP

• Physical Therapist in Dulles, VA
• Providers in Dulles, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.