NPIMap

Individual provider Active NPI

Shadi Razmdjou, MD

  • Gastroenterology Physician
  • Annapolis, MD
National Provider Identifier
1154703585
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
D0092146 Issued in MD
Practice address
621 Ridgely Ave Ste 201
Annapolis, MD 21401-1083
Phone
(410) 224-4887
Fax
(410) 224-1428
NPI assigned
Jun 22, 2015
Last updated
Oct 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X D0092146 MD Primary

Addresses

Primary practice location

621 Ridgely Ave Ste 201
Annapolis, MD 21401-1083

Mailing address

621 Ridgely Ave Ste 201
Annapolis, MD 21401-1083
Phone (410) 224-4887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211007000057 MD Practitioner - Gastroenterology 4082962170 Reassigns benefits to 1 organization
I20241001004500 PA Practitioner - Internal MedicinePractitioner - Gastroenterology 4082962170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

743 Jefferson Ave
Suite 203
Scranton, PA 18510-1638
Phone (570) 491-8141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as apm
Quality
78.34
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
59.44
Promoting interoperability
97
Improvement activities
40
Cost
81.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy16
Upper gastrointestinal (GI) endoscopy for acid reflux25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0092146MDMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Digestive Associates, PC Single Specialty CurrentSince May 1, 2022 Accepting new patients
Scranton Quincy Clinic Company LLC Single Specialty CurrentSince Oct 1, 2024 Accepting new patients
Wilkes-Barre Clinic Company LLC Single Specialty Past Accepting new patients

Locations

621 Ridgely Ave
Ste 201
Annapolis, MD 21401
Phone (410) 224-4887

150 Brooklyn St
Carbondale, PA 18407
Phone (570) 282-2031

315 S Main St
Old Forge, PA 18518
Phone (570) 457-8364

746 Jefferson Ave
Ste 203
Scranton, PA 18510
Phone (570) 344-9457

Interoperability endpoints

  • Direct secure messaging: shadi.razmdjou.1@21771.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1154703585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 RIDGELY AVE STE 201",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011083",
            "telephone_number": "410-224-4887",
            "fax_number": "410-224-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 RIDGELY AVE STE 201",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011083",
            "telephone_number": "410-224-4887",
            "fax_number": "410-224-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZMDJOU",
        "first_name": "SHADI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "D0092146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.