Individual provider Active NPI

Mariam McConnell Bahrami, M.D.

  • Internal Medicine Physician
  • Bowie, MD
National Provider Identifier
1003912742
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0057120 Issued in MD
Practice address
4379 Northview Dr
Bowie, MD 20716-2603
Phone
(301) 262-2627
Fax
(301) 262-8411
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0057120 MD Primary
Pediatrics Physician 208000000X D0057120 MD

Addresses

Primary practice location

4379 Northview Dr
Bowie, MD 20716-2603

Mailing address

4379 Northview Dr
Bowie, MD 20716-2603
Phone (301) 262-2627

Other identifiers 1

IdentifierTypeStateIssuer
820801800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110304000648 DC Practitioner - Internal MedicinePractitioner - Pediatric Medicine 0143402685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4379 Northview Dr
Bowie, MD 20716-2603
Phone (301) 262-2627

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bowie Primary Care, Inc Internal Medicine CurrentSince Jul 2, 2001 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4379 Northview Dr
Bowie, MD 20716
Phone (301) 262-2627

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1003912742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4379 NORTHVIEW DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207162603",
            "telephone_number": "301-262-2627",
            "fax_number": "301-262-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4379 NORTHVIEW DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207162603",
            "telephone_number": "301-262-2627",
            "fax_number": "301-262-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHRAMI",
        "first_name": "MARIAM",
        "middle_name": "MCCONNELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0057120",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0057120",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "820801800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.