Organization Active NPI

Northern Virginia Hematology Oncology Associates PC

  • Hematology & Oncology Physician
  • Woodbridge, VA
National Provider Identifier
1912064585
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
NORTHERN VIRGINIA HEMATOLOGY ONCOLOGY ASSOCIATES PC
Practice address
2079 Daniel Stuart SQ
Woodbridge, VA 22191-3317
Phone
(703) 491-5600
Fax
(703) 491-1744
NPI assigned
Jan 3, 2007
Last updated
Oct 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Authorized official

Name
Dr. Hamed Khosravi, MDNPI 1407802671
Title
Owner
Phone
(703) 491-5600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X NU Primary

Addresses

Primary practice location

2079 Daniel Stuart SQ
Woodbridge, VA 22191-3317

Mailing address

2079 Daniel Stuart SQ
Woodbridge, VA 22191-3317
Phone (703) 491-5600

Other identifiers 1

IdentifierTypeStateIssuer
1135OtherCAREFIRST BC BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070425000326 VA Part B Supplier - Clinic/Group Practice 2264537927 Receives reassigned benefits from 11 practitioners
Practice locations: Manassas, VA; Stafford, VA; Woodbridge, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D1080580Northern Virginia Hematology Oncology Associates2079 Daniel Stuart Square, Woodbridge, VA 22191ComplianceNov 11, 2027

National Provider Directory

National Provider Directory

Locations

8140 Ashton Ave
Ste 105
Manassas, VA 20109
Phone (703) 396-9000

8140 Ashton Ave
Ste 210
Manassas, VA 20109
Phone (703) 396-9000

125 Hospital Center Blvd
Ste 137
Stafford, VA 22554

125 Hospital Center Blvd
Ste 317
Stafford, VA 22554
Phone (540) 318-8201

2079 Daniel Stuart Sq
Woodbridge, VA 22191
Phone (703) 491-5600

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1912064585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2079 DANIEL STUART SQ",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913317",
            "telephone_number": "703-491-5600",
            "fax_number": "703-491-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2079 DANIEL STUART SQ",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913317",
            "telephone_number": "703-491-5600",
            "fax_number": "703-491-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN VIRGINIA HEMATOLOGY ONCOLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "KHOSRAVI",
        "authorized_official_first_name": "HAMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-491-5600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC BS",
            "identifier": "1135",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.