NPIMap

Individual provider Active NPI

Mirza M. Nusairee, M.D

  • Internal Medicine Physician
  • Crofton, MD
National Provider Identifier
1043257256
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0040519 Issued in MD
Practice address
1667 Crofton Ctr Ste 5
Crofton, MD 21114-1389
Phone
(410) 721-2700
Fax
(410) 721-8874
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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 D0040519 MD Primary

Addresses

Primary practice location

1667 Crofton Ctr Ste 5
Crofton, MD 21114-1389

Mailing address

1667 Crofton Ctr Ste 5
Crofton, MD 21114-1389
Phone (410) 721-2700

Other identifiers 1

IdentifierTypeStateIssuer
079341800MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL mirza.nusairee.1@14207.direct.athenahealth.com Direct

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
I20040306000130 MD Practitioner - Internal Medicine 4688562143 Reassigns benefits to 1 organization
Practice locations: Glen Burnie, MD

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1667 Crofton Ctr
Suite 5
Crofton, MD 21114-1303
Phone (410) 721-2700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crofton Medical Group, LLC Internal Medicine CurrentSince Jan 1, 2005 Accepting new patients
Ali Rezazadeh-Tehrani,M.D.,Inc. Past Accepting new patients
Mirza M. Nusairee, MD. Internal Medicine PastSince Jan 1, 1990 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1667 Crofton Ctr
Ste 1
Crofton, MD 21114
Phone (410) 721-2700

1667 Crofton Ctr
Ste 5
Crofton, MD 21114
Phone (410) 721-2700

1403 Madison Park Dr
Ste 300
Glen Burnie, MD 21061
Phone (410) 766-4747

Interoperability endpoints

  • Direct secure messaging: mirza.nusairee.1@14207.direct.athenahealth.com
  • Direct secure messaging: mnusairee23207@direct.umm.edu
  • FHIR API: https://api.platform.athenahealth.com/14207/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 9

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1043257256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1667 CROFTON CTR STE 5",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141389",
            "telephone_number": "410-721-2700",
            "fax_number": "410-721-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1667 CROFTON CTR STE 5",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141389",
            "telephone_number": "410-721-2700",
            "fax_number": "410-721-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSAIREE",
        "first_name": "MIRZA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0040519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079341800",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "mirza.nusairee.1@14207.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Our practice uses athenahealth for secure exchange of patient files, care data, and health information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1667 Crofton Ctr Ste 5",
            "city": "Crofton",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211141389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

Verify at the official NPI Registry.