NPIMap

Organization Active NPI

Maiden Choice Cardiac Diagnostic Center

  • Cardiovascular Disease Physician
  • Baltimore, MD
National Provider Identifier
1366491557
Registry record updated Aug 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MAIDEN CHOICE CARDIAC DIAGNOSTIC CENTER
Practice address
724 Maiden Choice LN
Suite 203
Baltimore, MD 21228-5911
Phone
(410) 455-0200
Fax
(410) 455-0009
NPI assigned
May 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2009

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

Authorized official

Name
Homayoon Moghbeli, MDNPI 1235118381
Title
MD
Phone
(410) 455-0200

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
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

724 Maiden Choice LN
Suite 203
Baltimore, MD 21228-5911

Mailing address

724 Maiden Choice LN
Suite 203
Baltimore, MD 21228-5911
Phone (410) 455-0200

Other identifiers 1

IdentifierTypeStateIssuer
174680400MedicaidMD

Other names 1

  • St. Agnes Cardiac Diagnostic Center Former legal business name

National Provider Directory

National Provider Directory

Locations

724 Maiden Choice Ln
Ste 203
Baltimore, MD 21228
Phone (410) 455-0200

Practitioners & affiliated clinicians

Practitioners 5

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": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1366491557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 MAIDEN CHOICE LN",
            "address_2": "SUITE 203",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212285911",
            "telephone_number": "410-455-0200",
            "fax_number": "410-455-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 MAIDEN CHOICE LN",
            "address_2": "SUITE 203",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212285911",
            "telephone_number": "410-455-0200",
            "fax_number": "410-455-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIDEN CHOICE CARDIAC DIAGNOSTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "MOGHBELI",
        "authorized_official_first_name": "HOMAYOON",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "410-455-0200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174680400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Agnes Cardiac Diagnostic Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Aug 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.