NPIMap

Organization Active NPI

Express Clinic LLC

  • Primary Care Clinic/Center
  • Catonsville, MD
National Provider Identifier
1285220830
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
EXPRESS CLINIC LLC
Practice address
724 Maiden Choice LN Ste 201
Catonsville, MD 21228-5962
Phone
(410) 650-4121
Fax
(866) 948-8535
NPI assigned
Dec 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Authorized official

Name
Jazibeh Qureshi, MDNPI 1831318583
Title
Owner
Phone
(410) 650-4121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

724 Maiden Choice LN Ste 201
Catonsville, MD 21228-5962

Mailing address

11321 Megan Lynn CT
Marriottsville, MD 21104-1658
Phone (410) 650-4121

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210308001445 MD Part B Supplier - Clinic/Group Practice 3577979038 Receives reassigned benefits from 2 practitioners
Practice locations: Catonsville, MD

National Provider Directory

National Provider Directory

Locations

724 Maiden Choice Ln
Ste 201
Catonsville, MD 21228
Phone (410) 650-4121

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25869/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632096000000",
    "number": "1285220830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11321 MEGAN LYNN CT",
            "city": "MARRIOTTSVILLE",
            "state": "MD",
            "postal_code": "211041658",
            "telephone_number": "410-650-4121",
            "fax_number": "266-948-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 MAIDEN CHOICE LN STE 201",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212285962",
            "telephone_number": "410-650-4121",
            "fax_number": "866-948-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A",
        "authorized_official_last_name": "QURESHI",
        "authorized_official_first_name": "JAZIBEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-650-4121",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Catonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.