Mohammad A. Amiri Sr.
Individual provider Active NPI Homemaker · Bristow, VA
NPI 1982575148 · NPPES record last updated Sep 12, 2025
Key facts
- NPI
- 1982575148
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Homemaker 376J00000X
- License
- 62743137 (VA)
- Practice address
- 9527 Moonen Bay LN
Bristow, VA 20136-3515 - Phone
- (609) 621-5926
- NPI assigned
- Sep 12, 2025
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62743137 | VA | MD | Homemaker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker |
376J00000X | 62743137 | VA | Yes |
Addresses
Primary practice location
9527 Moonen Bay LN
Bristow, VA 20136-3515
Mailing address
9527 Moonen Bay LN
Bristow, VA 20136-3515
Phone (609) 621-5926
Other providers in Bristow, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.