NPIMap

Individual provider Active NPI

Mariam Moiz Khambaty, M.D.

  • Infectious Disease Physician
  • Baltimore, MD
National Provider Identifier
1124080809
Registry record updated Aug 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
D0062074 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-6979
Fax
(410) 328-4430
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X D0062074 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

PO Box 64442
Baltimore, MD 21264-4442
Phone (410) 328-6979

Other identifiers 3

IdentifierTypeStateIssuer
64265201OtherMDBC/BS
036544200MedicaidDC
405906900MedicaidMD

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
I20041105000027 MD Practitioner - Infectious DiseasePractitioner - Internal Medicine 5698738243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Maryland Physicians PAGroup PAC ID 2769394808, 395 clinicians

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-8040

Hospital & facility affiliations

  • Bayada Home Health Care, Inc. Home health agency, Towson, MD, CCN 217101
  • Vna of Maryland Home health agency, Owings Mills, MD, CCN 217008
  • University of MD Medical Center Midtown Campus Hospital, Baltimore, MD, CCN 210038
  • University of Maryland Medical Center Hospital, Baltimore, MD, CCN 210002
  • Mercy Medical Center Inc Hospital, Baltimore, MD, CCN 210008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0062074MDMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Physicians PA Infectious Disease CurrentSince Sep 1, 2004 Accepting new patients
University of Maryland Physicians P.a. CurrentSince Sep 1, 2004 Accepting new patients
University of Maryland Physicians P.a. Current Accepting new patients
University of Maryland Physicians P.a. Infectious Disease Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

Interoperability endpoints

  • Direct secure messaging: mkhambaty6231@direct.umm.edu

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 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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1124080809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64442",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644442",
            "telephone_number": "410-328-6979",
            "fax_number": "410-328-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6979",
            "fax_number": "410-328-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMBATY",
        "first_name": "MARIAM",
        "middle_name": "MOIZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MD",
            "license": "D0062074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "64265201",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036544200",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405906900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.