Organization Active NPI

Diaa Y. Mikhail, M.D., P.a.

  • Family Medicine Physician
  • Baltimore, MD
National Provider Identifier
1316979636
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DIAA Y. MIKHAIL, M.D., P.A.
Practice address
1105 N Point Blvd
Suite 708
Baltimore, MD 21224-3419
Phone
(410) 288-5901
Fax
(410) 288-5904
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Authorized official

Name
Diaa Y. MikhailNPI 1558391227
Title
President
Phone
(410) 288-5901

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1105 N Point Blvd
Suite 708
Baltimore, MD 21224-3419

Mailing address

1105 N Point Blvd
Suite 708
Baltimore, MD 21224-3419
Phone (410) 288-5901

Other identifiers 5

IdentifierTypeStateIssuer
DG2297OtherGARAILROAD MEDICARE
KAV9DIOtherMDCAREFIRST
199301100OtherMDMEDICAL ASSISTANCE
271MOtherMDMEDICARE
S344 0001OtherDCCAREFIRST

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110607000330 MD Part B Supplier - Clinic/Group Practice 6507043239 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Locations

1105 N Point Blvd
Ste 708
Baltimore, MD 21224
Phone (410) 288-5901

1005 N Point Blvd
Ste 708
Baltimore, MD 21224
Phone (410) 288-5901

Practitioners & affiliated clinicians

Practitioners 1

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": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327017600000",
    "number": "1316979636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 N POINT BLVD",
            "address_2": "SUITE 708",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243419",
            "telephone_number": "410-288-5901",
            "fax_number": "410-288-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 N POINT BLVD",
            "address_2": "SUITE 708",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243419",
            "telephone_number": "410-288-5901",
            "fax_number": "410-288-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAA Y. MIKHAIL, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-01-20",
        "status": "A",
        "authorized_official_last_name": "MIKHAIL",
        "authorized_official_first_name": "DIAA",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-288-5901"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG2297",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "KAV9DI",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "199301100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "271M",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "S344  0001",
            "state": "DC"
        }
    ],
    "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 Jan 20, 2012; 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.