Individual provider Active NPI

Seyed Ali Fatemi, M.D., M.B.A.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Baltimore, MD
National Provider Identifier
1124148341
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
D67411 Issued in MD
Practice address
707 N Broadway
5TH Floor Towere
Baltimore, MD 21205-1832
Phone
(443) 923-9150
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 224324 MA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X D67411 MD Primary

Addresses

Primary practice location

707 N Broadway
5TH Floor Towere
Baltimore, MD 21205-1832

Mailing address

PO Box 64227
Baltimore, MD 21264-4227
Phone (410) 933-1329

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
I20080728000405 MD Practitioner - Neurology 7810061603 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
224324MAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Krieger Associates CurrentSince Jul 1, 2008 Accepting new patients
Johns Hopkins University CurrentSince May 6, 2012 Accepting new patients
Johns Hopkins University CurrentSince May 6, 2012 Accepting new patients
Johns Hopkins University Current Accepting new patients
Kennedy Krieger Associates CurrentSince Jul 1, 2008 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

707 N Broadway
Fl 5
Baltimore, MD 21205
Phone (443) 923-2783

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

801 N Broadway
Baltimore, MD 21205
Phone (443) 923-2600

600 N Wolfe St
Baltimore, MD 21287

Interoperability endpoints

  • Direct secure messaging: sfatemi9450@direct.kennedykrieger.org

Organizations & group practices 7

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1124148341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64227",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644227",
            "telephone_number": "410-933-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N BROADWAY",
            "address_2": "5TH FLOOR TOWERE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051832",
            "telephone_number": "443-923-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATEMI",
        "first_name": "SEYED ALI",
        "name_prefix": "Dr.",
        "credential": "M.D., M.B.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "224324",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MD",
            "license": "D67411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.