Active NPI
Mohammad Omar Malikasghar
- Surgery Physician
- Woodbridge, VA
National Provider Identifier
1912479692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 18-506
- Practice address
- 2300 Opitz Blvd
Woodbridge, VA 22191-3311 - Phone
- (703) 523-1000
- NPI assigned
- Dec 19, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 18-506 | VA | Primary |
Addresses
Primary practice location
2300 Opitz Blvd
Woodbridge, VA 22191-3311
Mailing address
2701 Neabsco Common PL Apt 314
Woodbridge, VA 22191-6706
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18-506 | VA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545177600000",
"number": "1912479692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 NEABSCO COMMON PL APT 314",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221916706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 OPITZ BLVD",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221913311",
"telephone_number": "703-523-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALIKASGHAR",
"first_name": "MOHAMMAD",
"middle_name": "OMAR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-19",
"last_updated": "2018-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "VA",
"license": "18-506",
"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 Dec 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.