Organization Active NPI

Woodbridge Internal Medicine, PC

  • Internal Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1912142076
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WOODBRIDGE INTERNAL MEDICINE, PC
Practice address
2022 Opitz Blvd
Suite B
Woodbridge, VA 22191-3323
Phone
(703) 910-7390
Fax
(703) 910-7392
NPI assigned
Dec 3, 2008
Last updated
Jan 21, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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

Authorized official

Name
Fardin Akrami, MD
Title
Owner
Phone
(703) 910-7390

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

2022 Opitz Blvd
Suite B
Woodbridge, VA 22191-3323

Mailing address

2022 Opitz Blvd
Suite B
Woodbridge, VA 22191-3323
Phone (703) 910-7390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090310000588 VA Part B Supplier - Clinic/Group Practice 5890851281 Receives reassigned benefits from 2 practitioners
Practice locations: Woodbridge, VA
O20090527000030 DC Part B Supplier - Clinic/Group Practice 5890851281 Receives reassigned benefits from 1 practitioner
Practice locations: Woodbridge, VA

National Provider Directory

National Provider Directory

Locations

2200 Opitz Blvd
Ste 235
Woodbridge, VA 22191
Phone (703) 491-4212

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1228262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358726400000",
    "number": "1912142076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 OPITZ BLVD",
            "address_2": "SUITE B",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913323",
            "telephone_number": "703-910-7390",
            "fax_number": "703-910-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 OPITZ BLVD",
            "address_2": "SUITE B",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913323",
            "telephone_number": "703-910-7390",
            "fax_number": "703-910-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODBRIDGE INTERNAL MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-03",
        "last_updated": "2013-01-21",
        "status": "A",
        "authorized_official_last_name": "AKRAMI",
        "authorized_official_first_name": "FARDIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-910-7390",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.