Dr Lana Adil Mahgoub, PHD, LP is a medicare enrolled "Psychologist - Clinical" provider in Dulles, Virginia. Her current practice location is
21525 Ridgetop Cir Ste 110, Dulles, Virginia. You can reach out to her office (for appointments etc.) via phone at
(703) 662-1719.
Dr Lana Adil Mahgoub is licensed to practice in Virginia (license number 0810006314) 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 1164912820.
Healthcare Provider's Profile
| Full Name | Dr Lana Adil Mahgoub |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 21525 Ridgetop Cir Ste 110, Dulles, 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: 1164912820
- Provider Enumeration Date: 05/17/2018
- Last Update Date: 10/21/2025
Medicare PECOS Information:
- PECOS PAC ID: 8426475872
- Enrollment ID: I20200831000826
Medical Identifiers
Medical identifiers for Dr Lana Adil Mahgoub such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164912820 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101Y00000X | Counselor | 11460 (Nebraska) | Secondary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | 0810006314 (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. Dr Lana Adil Mahgoub allows following entities to bill medicare on her behalf.
| Entity Name | Childrens Specialty Group Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1255354130
PECOS PAC ID: 5890788764
Enrollment ID: O20040406001195 |
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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. Dr Lana Adil Mahgoub 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 |
|---|
Dr Lana Adil Mahgoub, PHD, LP
21525 Ridgetop Cir Ste 110,
Dulles, VA 20166-6510
Ph: (703) 662-1719 | Dr Lana Adil Mahgoub, PHD, LP
21525 Ridgetop Cir Ste 110,
Dulles, VA 20166-6510
Ph: (703) 662-1719 |
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