Individual provider Active NPI

Martin Y Magram, M.D.

  • Nuclear Radiology Physician
  • Baltimore, MD
National Provider Identifier
1073611901
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Radiology PhysicianTaxonomy code 2085N0904X
License
D15540 Issued in MD
Practice address
3611 Gardenview Rd
Baltimore, MD 21208-1511
Phone
(301) 733-1031
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X D15540 MD Primary

Addresses

Primary practice location

3611 Gardenview Rd
Baltimore, MD 21208-1511

Mailing address

3611 Gardenview Rd
Baltimore, MD 21208-1511
Phone (301) 733-1031

Other identifiers 1

IdentifierTypeStateIssuer
789581000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20061106000215 MD Practitioner - Nuclear MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 8729085717 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Imaging Services, LLC CurrentSince Sep 1, 2006 Accepting new patients
Associated Radiologists, PA CurrentSince Jul 1, 2007 Accepting new patients
David L Bloom PA Past Accepting new patients
Shipley's Imaging, LLC Past Accepting new patients
David L Bloom PA Past Accepting new patients
University Imaging Center, LLC Nuclear Radiology Past Accepting new patients
University Imaging Center, LLC Nuclear Radiology Past Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Nuclear Radiology Past Accepting new patients

Locations

22 S Greene St
Rm N2E23
Baltimore, MD 21201
Phone (410) 328-5656

11110 Medical Campus Rd
Ste 245
Hagerstown, MD 21742
Phone (301) 714-4200

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

322 E Antietam St
Ste 106
Hagerstown, MD 21740

10715 Downsville Pike
Ste 103
Hagerstown, MD 21740
Phone (240) 313-9940

Organizations & group practices 8

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1073611901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 GARDENVIEW RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212081511",
            "telephone_number": "301-733-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 GARDENVIEW RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212081511",
            "telephone_number": "301-733-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGRAM",
        "first_name": "MARTIN",
        "middle_name": "Y",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "MD",
            "license": "D15540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "789581000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.