Keivan Gazy

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R224515 Issued in MD

Practice address

8115 Maple Lawn Blvd Ste 350
Fulton, MD 20759-2683

Phone

(240) 786-4527

NPI assigned

Mar 30, 2023

Last updated

Mar 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Esno Health GroupGroup PAC ID 4385057470, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.56 of 100Reported as individual

Quality

50.82

Improvement activities

40

Cost

77.45

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Esno Health Group

  • Psychiatry Physician
  • Fulton, MD
  • NPI 1740783539

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1225732357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8115 MAPLE LAWN BLVD STE 350",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8115 MAPLE LAWN BLVD STE 350",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592683",
            "telephone_number": "240-786-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZY",
        "first_name": "KEIVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R224515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gayle Friedman, MD
• London Fullerton
• Fulton Pediatric Dental
• Brandon Funderburke, PHARM D
• Seema Aliasgar Gadiwalla, M.D.
• Emiliya Gebru
• Aleksander Gee
• Michelle Gellis, MAC LAC
• Genuine Groups, Inc.
• Diyonna Genwright

• Psychiatric/Mental Health Nurse Practitioner in Fulton, MD
• Providers in Fulton, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.