Individual provider Active NPI

Mitra Keshtkarjahromi

  • Psychiatry Physician
  • El Paso, TX
National Provider Identifier
1093160046
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D88204 Issued in MD
Practice address
4800 Alberta Ave
El Paso, TX 79905-2709
Phone
(915) 215-8000
NPI assigned
Apr 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D88204 MD Primary

Addresses

Primary practice location

4800 Alberta Ave
El Paso, TX 79905-2709

Mailing address

4800 Alberta Ave
El Paso, TX 79905-2709
Phone (915) 215-8000

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
I20200715000549 MD Practitioner - Psychiatry 6406279058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Texas Tech University Health Science Center School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Maryland Psychiatry Associates PAGroup PAC ID 1052208253, 54 clinicians

Practice addresses (Care Compare)

701 W Pratt St
W
Baltimore, MD 21201-1023
Phone (410) 328-5881

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Maryland Central Payroll Bureau CurrentSince Sep 18, 2024 Accepting new patients
University of Maryland Psychiatry Associates, PA Psychiatry CurrentSince Jul 1, 2020 Accepting new patients
Comptroller of Maryland Central Payroll Bureau CurrentSince Sep 18, 2024 Accepting new patients
Comptroller of Maryland Central Payroll Bureau Current Accepting new patients
Maryland General Hospital Inc Past Accepting new patients

Locations

300 W Preston St
Ste 402
Baltimore, MD 21201
Phone (410) 767-2940

701 W Pratt St
Baltimore, MD 21201
Phone (410) 328-5881

6655 Sykesville Rd
Sykesville, MD 21784
Phone (410) 795-2100

Interoperability endpoints

  • Direct secure messaging: mitra.keshtkarjahromi@direct.myhealthep.org

Organizations & group practices 5

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 1

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": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1093160046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 ALBERTA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052709",
            "telephone_number": "915-215-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 ALBERTA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052709",
            "telephone_number": "915-215-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESHTKARJAHROMI",
        "first_name": "MITRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D88204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.