Individual provider Active NPI

Maryam Molahassani, MD

  • Emergency Medicine Physician
  • Columbia, MO
National Provider Identifier
1346914736
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2024032305 Issued in MO
Practice address
One Hospital Dr
Columbia, MO 65212-0001
Phone
(573) 882-8091
Fax
(573) 884-1902
NPI assigned
Aug 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2024032305 MO Primary

Addresses

Primary practice location

One Hospital Dr
Columbia, MO 65212-0001

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240826002420 MO Practitioner - Emergency Medicine 8325442569 Reassigns benefits to 1 organization
I20260324003705 TX Practitioner - Emergency Medicine 8325442569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Travis County Emergency Physicians PAGroup PAC ID 0840289468, 289 clinicians
Ripley Emergency Group LLCGroup PAC ID 1254757446, 35 clinicians

Practice addresses (Care Compare)

111 Dallas St
San Antonio, TX 78205-1201
Phone (210) 297-7000

1515 Union Ave
Moberly, MO 65270-9407
Phone (660) 263-8400

Hospital & facility affiliations

  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141
  • Moberly Regional Medical Center Hospital, Moberly, MO, CCN 260074

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2024032305MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ripley Emergency Group, LLC Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Curators of the University of Missouri CurrentSince Aug 14, 2024 Accepting new patients
The Curators of the University of Missouri CurrentSince Aug 14, 2024 Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

1 Hospital Dr
#2910
Columbia, MO 65212
Phone (573) 884-3233

1125 Madison St
Jefferson Cty, MO 65101
Phone (573) 632-5000

315 S Osteopathy Ave
Kirksville, MO 63501
Phone (660) 785-1000

1515 Union Ave
Moberly, MO 65270
Phone (660) 263-2400

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1346914736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-882-8091",
            "fax_number": "573-884-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLAHASSANI",
        "first_name": "MARYAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2024032305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "One Hospital Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652120001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.