DR. KOUROSH DIBADJ (NPI# 1487716593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487716593 |
| Entity Type | Individual |
| Full Name | DR. KOUROSH DIBADJ |
| Credential | M.D. |
| Practice Address |
13135 Lee Jackson Memorial Hwy 135 Fairfax VA 22033-1907 |
| Practice Telephone | 7039610488 |
| Practice Fax Number | 7039610480 |
| Mailing Telephone | 7039610488 |
| Mailing Fax Number | 7039610480 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2016-08-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
0101241367 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1487716593 | 05 |
| Street Address |
13135 LEE JACKSON MEMORIAL HWY 135 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22033-1907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811995467 | Robert E Greenspan | Internal Medicine | 13135 Lee Jackson Memorial Hwy, 135, Fairfax, VA 22033-1907 | 2005-07-08 |
| 1659842391 | Laura Roman | Pediatrics | 13135 Lee Jackson Memorial Hwy, Fairfax, VA 22033-1907 | 2018-12-06 |
| 1194267484 | Wellness and Preventative Care Centers LLC | Internal Medicine | 13135 Lee Jackson Memorial Hwy, Fairfax, VA 22033-1907 | 2016-11-17 |
| 1679981732 | Kelsey Schleider | Nurse Practitioner | 13135 Lee Jackson Memorial Hwy, Suite 201, Fairfax, VA 22033-1907 | 2014-07-31 |
| 1417387101 | Jocelyn Marie Smith | Nurse Practitioner | 13135 Lee Jackson Memorial Hwy, Fairfax, VA 22033-1907 | 2013-11-18 |
| 1811332448 | Madeline R Wolfert | Pediatrics | 13135 Lee Jackson Memorial Hwy, Suite 201, Fairfax, VA 22033-1907 | 2013-05-09 |
| 1265773824 | Joanna L Casey | Nurse Practitioner | 13135 Lee Jackson Memorial Hwy, Suite 201, Fairfax, VA 22033-1907 | 2013-03-07 |
| 1639432198 | Nowal Al Baqui | Internal Medicine | 13135 Lee Jackson Memorial Hwy, #135, Fairfax, VA 22033-1907 | 2012-06-20 |
| 1942450267 | Misbah Zaheer | Internal Medicine | 13135 Lee Jackson Memorial Hwy, Ste 135, Fairfax, VA 22033-1907 | 2008-09-23 |
| 1154578466 | Patricia A Mcdade | Nurse Practitioner | 13135 Lee Jackson Memorial Hwy, Suite 201, Fairfax, VA 22033-1907 | 2008-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366074320 | Han S Yoo | Pharmacist | 12200 West Ox Road, Fairfax, VA 22033 | 2020-02-07 |
| 1386137271 | Ammar Orthodontics Pllc | Dentist | 11702 Fiar Oaks Mall, Upper Floor, Fairfax, VA 22033 | 2018-06-14 |
| 1013360940 | Kellyn Patricia Dodd | Nurse Practitioner | 3903 Fair Ridge Dr Ste 209, Fairfax, VA 22033 | 2016-07-15 |
| 1659721363 | John Du Od PC | Optometrist | 12618 Victoria Station Ct, Fairfax, VA 22033 | 2016-06-14 |
| 1568861904 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12734 Shoppes Lane, Fairfax, VA 22033 | 2014-08-21 |
| 1649696295 | Patrisha Lultschik | Nurse Practitioner | 12375 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2014-03-06 |
| 1912321910 | Alyson Huber | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr., Fairfax, VA 22033 | 2014-02-11 |
| 1578999314 | Aiatulah Surmaty | Optometrist | 11801 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2013-09-25 |
| 1356780928 | Ayatallah M. Khafagy | Obstetrics & Gynecology | 3650 Joseph Siewick Dr Suite 203, Fairfax, VA 22033 | 2013-06-17 |
| 1760726665 | Michelle Elise Schwartz | Speech-Language Pathologist | 3507 Curtice Farm Dr, Fairfax, VA 22033 | 2012-11-15 |
| Find all providers in zip 22033 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598080186 | Vineet Kumaar Jassal | Internal Medicine | 3930 Walnut St Ste 101, Fairfax, VA 22030-4750 | 2010-04-07 |
| 1770632630 | Northern Virginia Nephrology Associates PC | Internal Medicine | 8505 Arlington Blvd Ste 340, Fairfax, VA 22031 | 2007-01-09 |
| 1295820827 | Kinjal Ramesh Patel | Internal Medicine | 3930 Walnut Street, Suite 101, Fairfax, VA 22030-4738 | 2006-10-03 |
| 1811995467 | Robert E Greenspan | Internal Medicine | 13135 Lee Jackson Memorial Hwy, 135, Fairfax, VA 22033-1907 | 2005-07-08 |
| 1639432198 | Nowal Al Baqui | Internal Medicine | 13135 Lee Jackson Memorial Hwy, #135, Fairfax, VA 22033-1907 | 2012-06-20 |
| 1285912857 | Caroline Kwon | Internal Medicine | 3930 Walnut St, Suite 101, Fairfax, VA 22030-4738 | 2011-07-29 |
| 1942450267 | Misbah Zaheer | Internal Medicine | 13135 Lee Jackson Memorial Hwy, Ste 135, Fairfax, VA 22033-1907 | 2008-09-23 |
| 1871778068 | Gregory Wang | Internal Medicine | 13135 Lee Jackson Memorial Hwy, #135, Fairfax, VA 22033-1907 | 2008-01-07 |
| 1700954252 | Anup Manoharan | Internal Medicine | 8316 Arlington Blvd, Suite 104, Fairfax, VA 22031-5207 | 2006-12-01 |
| 1225124779 | Renuka Sothinathan | Internal Medicine | 3930 Walnut Street, Suite 101, Fairfax, VA 22030-4738 | 2006-10-04 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.