NPIMap

Individual provider Active NPI

Adam Iddriss, MD

  • Surgery Physician
  • Baltimore, MD
National Provider Identifier
1215291463
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A171375 Issued in CA
Practice address
Johns Hopkins Hospital
600 N. Wolfe Street, Blalock 658
Baltimore, MD 21287-0001
Phone
(412) 508-5573
NPI assigned
Jul 2, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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
Surgery Physician 208600000X A171375 CA Primary

Addresses

Primary practice location

Johns Hopkins Hospital
600 N. Wolfe Street, Blalock 658
Baltimore, MD 21287-0001

Mailing address

34875 Pourroy Rd 2504
Winchester, CA 92596-4423
Phone (412) 508-5573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A171375CAMDSurgery Physician

Interoperability endpoints

  • Direct secure messaging: aiddriss106204@direct.ynhh.org

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1215291463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34875 POURROY RD 2504",
            "city": "WINCHESTER",
            "state": "CA",
            "postal_code": "925964423",
            "telephone_number": "412-508-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JOHNS HOPKINS HOSPITAL",
            "address_2": "600 N. WOLFE STREET, BLALOCK 658",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870001",
            "telephone_number": "412-508-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDDRISS",
        "first_name": "ADAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-02",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A171375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.