Individual provider Active NPI

Adelaida Matevosyan, MD

  • Infectious Disease Physician
  • Westminster, MD
National Provider Identifier
1205299930
Registry record updated Jun 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
D0091199 Issued in MD
Practice address
826 Washington Rd Ste 204a
Westminster, MD 21157-5780
Phone
(410) 525-5144
NPI assigned
Mar 31, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2021

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 D0091199 MD Primary

Addresses

Primary practice location

826 Washington Rd Ste 204a
Westminster, MD 21157-5780

Mailing address

826 Washington Rd Ste 204a
Westminster, MD 21157-5780
Phone (410) 525-5144

Other practice location 1

3001 S Hanover St
Baltimore, MD 21225-1233
Phone (410) 350-3565

Other practice location 2

420 Delaware St SE
Minneapolis, MN 55455-0341
Phone (612) 625-6256

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address id-ed@umn.edu Direct

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
I20210914000037 MD Practitioner - Infectious Disease 0840526398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sumit Bhutani, MD LLCGroup PAC ID 5799094892, 4 clinicians

Practice addresses (Care Compare)

826 Washington Rd
Westminster, MD 21157-5780
Phone (410) 525-5144

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0091199MDMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sumit Bhutani, MD LLC CurrentSince Sep 10, 2021 Accepting new patients

Locations

5415 Old Court Rd
Ste 101
Randallstown, MD 21133
Phone (410) 308-7855

826 Washington Rd
Ste 204A
Westminster, MD 21157
Phone (410) 525-5144

Interoperability endpoints

  • Direct secure messaging: adelaida.matevosyan.1@16725.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/16725/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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 6

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": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624060800000",
    "number": "1205299930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 WASHINGTON RD STE 204A",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575780",
            "telephone_number": "410-525-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 WASHINGTON RD STE 204A",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575780",
            "telephone_number": "410-525-5144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3001 S Hanover St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212251233",
            "country_code": "US",
            "telephone_number": "410-350-3565",
            "fax_number": "410-354-0186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "420 Delaware St SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550341",
            "country_code": "US",
            "telephone_number": "612-625-6256",
            "fax_number": "612-625-4410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATEVOSYAN",
        "first_name": "ADELAIDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-31",
        "last_updated": "2021-06-19",
        "certification_date": "2021-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MD",
            "license": "D0091199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "id-ed@umn.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "420 Delaware St SE",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554550341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

Verify at the official NPI Registry.