Individual provider Active NPI

Simin Sistani, M.D.

  • Legal Medicine
  • Towson, MD
National Provider Identifier
1396785192
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
D0064104 Issued in MD
Practice address
25 Dunvale Rd
Apt 572
Towson, MD 21204-2521
Phone
(410) 296-2399
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X D0064104 MD Primary

Addresses

Primary practice location

25 Dunvale Rd
Apt 572
Towson, MD 21204-2521

Mailing address

25 Dunvale Rd.
Apt 572
Towson, MD 21204
Phone (410) 296-2399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060928000607 MD Practitioner - Internal Medicine 8426053273 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

5601 Lloch Raven Blvd
Baltimore, MD 21239-2945
Phone (443) 444-8000

Hospital & facility affiliations

  • Medstar Good Samaritan Hospital Hospital, Baltimore, MD, CCN 210056
  • Medstar Union Memorial Hospital Hospital, Baltimore, MD, CCN 210024

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0064104MDMDLegal Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jul 1, 2021 Accepting new patients
Adfinitas Health at Upper Chesapeake Harford Memorial LLC CurrentSince Jul 15, 2023 Accepting new patients
Adfinitas Health at Upper Chesapeake, LLC CurrentSince Jul 15, 2023 Accepting new patients
Upper Chesapeake Medical Services, Inc CurrentSince Nov 8, 2011 Accepting new patients
Adfinitas Health at Upper Chesapeake Aberdeen LLC CurrentSince Jul 15, 2023 Accepting new patients
Gary a Pichney DPM Past Accepting new patients
The Good Samaritan Hospital of Maryland, Inc Past Accepting new patients

Locations

660 McHenry Rd
Aberdeen, MD 21001
Phone (443) 643-1500

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

500 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (443) 643-1000

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

501 S Union Ave
Hvre de Grace, MD 21078
Phone (301) 939-2400

Organizations & group practices 7

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 2

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396785192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 DUNVALE RD.",
            "address_2": "APT 572",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "21204",
            "telephone_number": "410-296-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 DUNVALE RD",
            "address_2": "APT 572",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042521",
            "telephone_number": "410-296-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISTANI",
        "first_name": "SIMIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "MD",
            "license": "D0064104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.