Samira Mortazavi, CNM, WHNP-BC is a medicare enrolled "Midwife" in Fairfax, Virginia. Her current practice location is
8620 Willow Oaks Corp Drive, Suite 350, Fairfax, Virginia. You can reach out to her office (for appointments etc.) via phone at
(703) 260-1179.
Samira Mortazavi is licensed to practice in Virginia (license number CNM09417) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1215772926.
Provider's Profile
| Full Name | Samira Mortazavi |
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| Gender | Female |
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| Speciality | Midwife |
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| Location | 8620 Willow Oaks Corp Drive, Fairfax, Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1215772926
- Provider Enumeration Date: 06/26/2024
- Last Update Date: 06/26/2024
Medicare PECOS Information:
- PECOS PAC ID: 9830624568
- Enrollment ID: I20241119000454
Medical Identifiers
Medical identifiers for Samira Mortazavi such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1215772926 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LW0102X | Nurse Practitioner - Women's Health | 104118811 (Virginia) | Secondary |
| 176B00000X | Midwife | CNM09417 (Virginia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samira Mortazavi allows following entities to bill medicare on her behalf.
| Entity Name | Inova Health Care Services |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1952320061
PECOS PAC ID: 2466351093
Enrollment ID: O20040102000644 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samira Mortazavi is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Samira Mortazavi, CNM, WHNP-BC
421 Springvale Rd,
Great Falls, VA 22066-3426
Ph: (703) 999-2578 | Samira Mortazavi, CNM, WHNP-BC
8620 Willow Oaks Corp Drive, Suite 350,
Fairfax, VA 22031
Ph: (703) 260-1179 |
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