Individual provider Active NPI

Hamid R Khairghadam, CRNA

  • Certified Registered Nurse Anesthetist
  • Bel Air, MD
National Provider Identifier
1205862190
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R137569 Issued in MD
Practice address
500 Upperchesapeake Dr
Belair, MD 21014
Phone
(410) 420-7630
NPI assigned
Jun 23, 2006
Last updated
Aug 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R137569 MD Primary

Addresses

Primary practice location

500 Upperchesapeake Dr
Belair, MD 21014

Mailing address

2060 Phillips Mill Rd
Forest Hill, MD 21050-2119
Phone (410) 420-7630

Other identifiers 1

IdentifierTypeStateIssuer
435101100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101104001081 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880888783 Reassigns benefits to 4 organizations
I20140606000406 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880888783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 Upper Chesapeake Dr
Bel Air, MD 21014-4324
Phone (443) 643-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R137569MDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Surgery Associates, L.L.C. CurrentSince Nov 9, 2019 Accepting new patients
Capital Anesthesia Partners, LLC CurrentSince Apr 1, 2014 Accepting new patients
Vascular Surgery Associates, L.L.C. CurrentSince Nov 9, 2019 Accepting new patients
Upper Bay Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2015 Accepting new patients
Northern Chesapeake Anesthesia Associates Past Accepting new patients

Locations

2021 K St NW
Ste T120
Washington, DC 20006
Phone (202) 775-0574

3435 Box Hill Corporate Center Dr
Ste H
Abingdon, MD 21009
Phone (410) 879-2006

520 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (410) 836-0128

520 Upper Chesapeake Dr
Ste 306
Bel Air, MD 21014
Phone (410) 879-2006

103 Chesapeake Blvd
Ste C
Elkton, MD 21921
Phone (410) 392-6133

6569 N Charles St
Ste 701
Towson, MD 21204
Phone (410) 825-4928

Interoperability endpoints

  • Direct secure messaging: hkhairghadam651693@direct.umm.edu
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1205862190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 PHILLIPS MILL RD",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502119",
            "telephone_number": "410-420-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UPPERCHESAPEAKE DR",
            "city": "BELAIR",
            "state": "MD",
            "postal_code": "21014",
            "telephone_number": "410-420-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIRGHADAM",
        "first_name": "HAMID",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R137569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435101100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.