NPIMap

Individual provider Active NPI

Hasan Imanli, MD

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1205325628
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0090861 Issued in MD
Practice address
821 N Eutaw St Ste 308
Baltimore, MD 21201-6303
Phone
(410) 383-2072
Fax
(410) 383-0054
NPI assigned
May 2, 2018
Last updated
Jul 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X D0090861 MD Primary

Addresses

Primary practice location

821 N Eutaw St Ste 308
Baltimore, MD 21201-6303

Mailing address

821 N Eutaw St Ste 308
Baltimore, MD 21201-6303
Phone (410) 383-2072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20210712001009 MD Practitioner - Internal Medicine 7416359641 Reassigns benefits to 1 organization
I20210818001240 DC Practitioner - Internal Medicine 7416359641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1051 Brightseat Rd
Landover, MD 20785-3738
Phone (410) 383-2072

821 N Eutaw St
Suite 308
Baltimore, MD 21201-6303
Phone (410) 383-2072

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Symphony Medical Associates, PA CurrentSince Jul 1, 2021 Accepting new patients
Alice Operator LLC Past Accepting new patients
Pikesville Operator, LLC Past Accepting new patients
Ridge (MD) Leasing Co., LLC Past Accepting new patients

Locations

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

821 N Eutaw St
Ste 308
Baltimore, MD 21201
Phone (410) 383-2072

9106 Pine View Ln
Clinton, MD 20735
Phone (301) 856-2930

1051 Brightseat Rd
Landover, MD 20785
Phone (240) 487-4400

Interoperability endpoints

  • Direct secure messaging: himanli220658@direct.umm.edu

Organizations & group practices 4

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 4

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": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1205325628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 N EUTAW ST STE 308",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212016303",
            "telephone_number": "410-383-2072",
            "fax_number": "410-383-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 N EUTAW ST STE 308",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212016303",
            "telephone_number": "410-383-2072",
            "fax_number": "410-383-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMANLI",
        "first_name": "HASAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-02",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0090861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.