DAVOUD MOHTAT M.D.
NPI 1639483373
Pediatrics - Pediatric Nephrology in Fairfax, VA
About Davoud Mohtat M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAVOUD MOHTAT M.D. (NPI 1639483373) is an individual pediatric nephrology provider in Fairfax, Virginia, licensed in Virginia (0101253093) and active in the NPI registry since August 2010. He is enrolled in Medicare PECOS and is a graduate of Other (1998).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Davoud Mohtat M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
4Medicare enrollment records show Davoud Mohtat reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fairfax, VA 22031
- Reassigned Medicare billing, District of Columbia enrollment
- 128 clinicians in this Medicare group
Fairfax, VA 22031
- Reassigned Medicare billing, District of Columbia and Virginia enrollments
- 2,618 clinicians in this Medicare group
Washington, DC 20007
- Reassigned Medicare billing, District of Columbia enrollment
- 3,530 clinicians in this Medicare group
Washington, DC 20007
- Reassigned Medicare billing, District of Columbia enrollment
- 861 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FAIRFAX, VA 22031
FAIRFAX, VA 22031
FAIRFAX, VA 22031
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Davoud Mohtat's NPI number?
The NPI number for Davoud Mohtat is 1639483373. It was assigned to this individual provider in the NPPES registry on August 5, 2010.
Where is Davoud Mohtat located?
Davoud Mohtat practices at 3023 Hamaker Ct Suite 600, Fairfax, VA 22031. The listed phone number is (703) 876-2788.
What is Davoud Mohtat's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Nephrology, with taxonomy code 2080P0210X.
Is Davoud Mohtat enrolled in Medicare?
Yes. Davoud Mohtat is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Davoud Mohtat's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Davoud Mohtat reassigns Medicare benefits to 4 organizations: Pediatric Specialists Of Virginia, LLC (Fairfax, VA), Inova Health Care Services (Fairfax, VA), Medstar Medical Group II LLC (Washington, DC) and Mgmc LLC (Washington, DC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Davoud Mohtat's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Davoud Mohtat was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Davoud Mohtat, M.D. · NPI 1639483373
Pediatric Nephrology physician in Fairfax, Virginia. Individual provider, active in the CMS NPPES registry since August 5, 2010.
## Identity
- **NPI:** 1639483373 (Entity type: Individual)
- **Enumerated:** August 5, 2010
- **Primary specialty:** Pediatrics - Pediatric Nephrology · taxonomy 2080P0210X
- **State license:** 0101253093 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 3023 HAMAKER CT, SUITE 600, Fairfax, VA 22031-2207
- **Phone:** (703) 876-2788
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Pediatric Specialists Of Virginia, LLC (NPI 1699119818, Fairfax, VA); Inova Health Care Services (NPI 1669511051, Fairfax, VA); Medstar Medical Group II LLC (NPI 1205562816, Washington, DC); Mgmc LLC (NPI 1316949654, Washington, DC) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1998
## Record status
- **NPPES last updated:** November 27, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1639483373) · Data from the CMS NPPES public registry.