MEDICARE: KINETIC MANAGEMENT AND CONSULTING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1598623001
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINETIC MANAGEMENT AND CONSULTING LLC

Provider Business Mailing Address
First Line	:	2497 PORT POTOMAC AVE
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-3070
Country	:	US
Telephone Number	:	804-286-2136
Fax Number	:

Provider Business Practice Location Address
First Line	:	2497 PORT POTOMAC AVE
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191
Country	:	US
Telephone Number	:	703-859-4977
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	ANDLEEB TAHIR KHAN
Credential	:
Telephone Number	:	703-859-4977

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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