NPIMap

Individual provider Active NPI

Tamader H Mira, M.D.

  • Internal Medicine Physician
  • Brooklyn, MD
National Provider Identifier
1023205887
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0066019 Issued in MD
Practice address
5505 Ritchie Hwy
E
Brooklyn, MD 21225-3444
Phone
(410) 355-0340
Fax
(410) 636-3403
NPI assigned
Sep 26, 2007
Last updated
Oct 19, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0066019 MD Primary

Addresses

Primary practice location

5505 Ritchie Hwy
E
Brooklyn, MD 21225-3444

Mailing address

5505 Ritchie Hwy
E
Brooklyn, MD 21225-3444
Phone (410) 355-0340

Other identifiers 1

IdentifierTypeStateIssuer
413777900MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080327000302 MD Practitioner - Internal Medicine 4880777549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5505 Ritchie Hwy
Suite E
Brooklyn, MD 21225-3481
Phone (410) 355-0340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0066019MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Tamader H. Mira, P.a. Internal Medicine CurrentSince Sep 1, 2007 Accepting new patients
Medstar Harbor Hospital Physicians LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5505 Ritchie Hwy
Ste E
Brooklyn Park, MD 21225
Phone (410) 355-0340

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDJDCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/IDJDCD/Endpoint/IDJDCD
  • Direct secure messaging: tmira22930@direct.umm.edu

Organizations & group practices 3

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

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1023205887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 RITCHIE HWY",
            "address_2": "E",
            "city": "BROOKLYN",
            "state": "MD",
            "postal_code": "212253444",
            "telephone_number": "410-355-0340",
            "fax_number": "410-636-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 RITCHIE HWY",
            "address_2": "E",
            "city": "BROOKLYN",
            "state": "MD",
            "postal_code": "212253444",
            "telephone_number": "410-355-0340",
            "fax_number": "410-636-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRA",
        "first_name": "TAMADER",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0066019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "413777900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, MD

Sources for this page

Verify at the official NPI Registry.