Individual provider Active NPI

Pouya Mahmoudian Esfahani

  • Chiropractor
  • Wheaton, MD
National Provider Identifier
1245911478
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S04152 Issued in MD
Practice address
11263 Triangle LN
Wheaton, MD 20902-4635
Phone
(832) 686-7471
NPI assigned
Jul 31, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S04152 MD Primary

Addresses

Primary practice location

11263 Triangle LN
Wheaton, MD 20902-4635

Mailing address

2511 Glenallan Ave Apt 265
Silver Spring, MD 20906-3584
Phone (832) 686-7471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240726003343 DC Practitioner - Chiropractic 6800332750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pain Relief ChiropracticGroup PAC ID 9537605480, 2 clinicians

Practice addresses (Care Compare)

11263 Triangle LN
Silver Spring, MD 20902-4635
Phone (240) 833-8169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S04152MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Relief Chiropractic Chiropractor CurrentSince Jul 1, 2024 Accepting new patients

Locations

11263 Triangle Ln
Wheaton, MD 20902
Phone (240) 833-8169

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.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1245911478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 GLENALLAN AVE APT 265",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209063584",
            "telephone_number": "832-686-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11263 TRIANGLE LN",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209024635",
            "telephone_number": "832-686-7471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOUDIAN ESFAHANI",
        "first_name": "POUYA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S04152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.