Individual provider Active NPI

Kambiz Tajkarimi, MD

  • Urology Physician
  • Leesburg, VA
National Provider Identifier
1942326251
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
0101257572 Issued in VA
Practice address
44055 Riverside Pkwy Ste 208
Leesburg, VA 20176-5176
Phone
(703) 687-3601
Fax
(703) 687-3602
NPI assigned
Mar 21, 2007
Last updated
Jun 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 0101257572 VA Primary

Addresses

Primary practice location

44055 Riverside Pkwy Ste 208
Leesburg, VA 20176-5176

Mailing address

44055 Riverside Pkwy Ste 208
Leesburg, VA 20176-5176
Phone (703) 687-3601

Other identifiers 2

IdentifierTypeStateIssuer
1021322530002MedicaidPA
867633OtherPAMEDICARE GROUP #

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170828001116 VA Practitioner - Urology 2365518974 Reassigns benefits to 2 organizations
I20180531002156 DC Practitioner - Urology 2365518974 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3700 Joseph Siewick Dr
Fairfax, VA 22033-1738
Phone (703) 687-3601

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients
Urology Health Consulting PC Urology CurrentSince Jul 20, 2017 Accepting new patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients
Inova Health Care Services Current Accepting new patients
Franklin County Foot & Ankle Center LLC PastSince Jul 1, 2002 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3700 Joseph Siewick Dr
Ste 206
Fairfax, VA 22033
Phone (703) 393-0700

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44055 Riverside Pkwy
Ste 208
Leesburg, VA 20176
Phone (703) 729-7652

44055 Riverside Pkwy
Ste 226
Leesburg, VA 20176
Phone (202) 321-8162

8180 Greensboro Dr
Ste 300
McLean, VA 22102
Phone (703) 810-5217

Interoperability endpoints

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

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1942326251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44055 RIVERSIDE PKWY STE 208",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201765176",
            "telephone_number": "703-687-3601",
            "fax_number": "703-687-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44055 RIVERSIDE PKWY STE 208",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201765176",
            "telephone_number": "703-687-3601",
            "fax_number": "703-687-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAJKARIMI",
        "first_name": "KAMBIZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101257572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021322530002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "867633",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.