NPIMap

Organization Active NPI

Khosrow Davachi MD PC

  • Nephrology Physician
  • Clinton, MD
National Provider Identifier
1295944957
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
D0025640 Issued in MD
Legal business name
KHOSROW DAVACHI MD PC
Practice address
7700 Old Branch Ave Ste D203
Clinton, MD 20735-1611
Phone
(301) 868-7121
Fax
(301) 877-1934
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Authorized official

Name
Dr. Khosrow Davachi, MDNPI 1295812899
Title
President Owner
Phone
(301) 868-7121

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
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X D0025640 MD Primary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X MD8172 DC

Addresses

Primary practice location

7700 Old Branch Ave Ste D203
Clinton, MD 20735-1611

Mailing address

7700 Old Branch Ave Ste D203
Clinton, MD 20735-1611
Phone (301) 868-7121

Other practice location 1

6196 Oxon Hill Rd Ste 290D203
Oxon Hill, MD 20745-3100
Phone (301) 868-7121

Other identifiers 17

IdentifierTypeStateIssuer
205102800MedicaidMD
30859001OtherMDBX MARYLAND
417465OtherMAMSI
CH8837OtherMDRAILROAD MEDICARE
048343500MedicaidDC
05722MedicaidDC
10094MedicaidDC
CH8837OtherDCRAILROAD MEDICARE
05722MedicaidMD
0734041012OtherCIGNA
097999OtherVAANTHEM BX
175743OtherMEDICARE
4050444OtherAETNA
4954MedicaidDC
0771 0001OtherDCBX DC
0771 0001OtherDCBLUE CHOICE
27555MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100414000022 DC Part B Supplier - Clinic/Group Practice 6901932466 Receives reassigned benefits from 1 practitioner
Practice locations: Clinton, MD; Oxon Hill, MD
O20170726000790 MD Part B Supplier - Clinic/Group Practice 6901932466 Receives reassigned benefits from 1 practitioner
Practice locations: Waldorf, MD

National Provider Directory

National Provider Directory
Tax ID family
Khosrow Davachi MD PC M2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7700 Old Branch Ave
Ste D204
Clinton, MD 20735
Phone (301) 868-7121

7700 Old Branch Ave
Ste D203
Clinton, MD 20735
Phone (301) 868-1220

6196 Oxon Hill Rd
Ste 290D203
Oxon Hill, MD 20745
Phone (301) 868-7121

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752019200000",
    "number": "1295944957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 OLD BRANCH AVE STE D203",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351611",
            "telephone_number": "301-868-7121",
            "fax_number": "301-868-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 OLD BRANCH AVE STE D203",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351611",
            "telephone_number": "301-868-7121",
            "fax_number": "301-877-1934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6196 Oxon Hill Rd Ste 290D203",
            "address_purpose": "LOCATION",
            "city": "Oxon Hill",
            "state": "MD",
            "postal_code": "207453100",
            "country_code": "US",
            "telephone_number": "301-868-7121",
            "fax_number": "301-868-7968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KHOSROW DAVACHI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A",
        "authorized_official_last_name": "DAVACHI",
        "authorized_official_first_name": "KHOSROW",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "301-868-7121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": "D0025640",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "DC",
            "license": "MD8172",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205102800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BX MARYLAND",
            "identifier": "30859001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "417465",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH8837",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048343500",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05722",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10094",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH8837",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05722",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0734041012",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BX",
            "identifier": "097999",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "175743",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4050444",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4954",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BX DC",
            "identifier": "0771 0001",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "0771 0001",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27555",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; 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.