NPIMap

Individual provider Active NPI

Nader Tavakoli-Jalili, MD

  • Family Medicine Physician
  • Largo, MD
National Provider Identifier
1407059413
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0041978 Issued in MD
Practice address
9500 Medical Center Dr # 3230-F
Largo, MD 20774-3701
Phone
(301) 352-7118
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X D0041978 MD
Family Medicine Physician 207Q00000X D0041978 MD Primary

Addresses

Primary practice location

9500 Medical Center Dr # 3230-F
Largo, MD 20774-3701

Mailing address

626C Admiral Dr
# 235
Annapolis, MD 21401-2151
Phone (301) 352-7118

Other identifiers 2

IdentifierTypeStateIssuer
305791700MedicaidMD
B181OtherMDBCBS PROV #

Other names 1

  • Dr. Nader Tavakoli Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100921000678 DC Practitioner - Family Practice 0143272922 Reassigns benefits to 4 organizations
I20100921001099 MD Practitioner - Family Practice 0143272922 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dimensions Healthcare Associates, IncGroup PAC ID 1557269743, 198 clinicians

Practice addresses (Care Compare)

2900 Mercy LN
Cheverly, MD 20785-1157
Phone (301) 618-2773

Hospital & facility affiliations

  • Heartland Hospice (Beltsville) Hospice, Beltsville, MD, CCN 211542
  • Wilson Health Care Center Nursing home, Gaithersburg, MD, CCN 215099
  • Ginger Cove Nursing home, Annapolis, MD, CCN 215174

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dimensions Healthcare Associates Inc CurrentSince Mar 4, 2014 Accepting new patients
Dimensions Health Associates Dba University of Maryland Capital Region CurrentSince Mar 4, 2014 Accepting new patients
Alignmed Medical Group, PC CurrentSince Sep 11, 2024 Accepting new patients
Genesis Eldercare Physician Services LLC CurrentSince Jul 30, 2021 Accepting new patients
Dimensions Healthcare Associates, Inc. Current Accepting new patients
Genesis Eldercare Physician Services LLC CurrentSince Jul 30, 2021 Accepting new patients
Alignmed Partners, PC CurrentSince Jul 30, 2021 Accepting new patients
Genesis Eldercare Physician Services LLC CurrentSince Jul 30, 2021 Accepting new patients
The Village at Rockville, Inc. Past Accepting new patients

Locations

3330 Wilkens Ave
Baltimore, MD 21229
Phone (410) 525-1544

2900 Mercy Ln
Cheverly, MD 20785
Phone (301) 618-2010

7520 Surratts Rd
Clinton, MD 20735
Phone (301) 856-1600

347 Ballenger Center Dr
Frederick, MD 21703
Phone (301) 633-5181

4000 Garden City Dr
Ste 810
Hyattsville, MD 20785
Phone (240) 667-3100

1801 Wentworth Rd
Parkville, MD 21234
Phone (410) 661-5717

9200 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 390-2600

310 Genesis Way
Ste 600
Severna Park, MD 21146
Phone (410) 544-4220

3227 Bel Pre Rd
Silver Spring, MD 20906
Phone (301) 871-2000

2101 Fairland Rd
Silver Spring, MD 20904
Phone (301) 384-6161

Ownership & related parties

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Larkin Chase CenterBowie, MD, CCN 215264 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2024
Mar 1, 2024
Herman M. Wilson Health Care CenterGaithersburg, MD, CCN 215099 Skilled nursing facility Adp of the SNF Apr 4, 2025
Asbury SolomonsSolomons, MD, CCN 215304 Skilled nursing facility Adp of the SNF Jul 1, 2022
Autumn Lake Healthcare at Cherry LaneLaurel, MD, CCN 215177 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2024
May 1, 2024
Autumn Lake Healthcare at Glen BurnieGlen Burnie, MD, CCN 215266 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2023
Oct 1, 2023
Autumn Lake Healthcare at Patuxent RiverLaurel, MD, CCN 215141 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2024
Oct 1, 2024
Autumn Lake Healthcare at Silver SpringSilver Spring, MD, CCN 215224 Skilled nursing facility Adp of the SNF Jun 1, 2023
Autumn Lake Healthcare at Chevy ChaseChevy Chase, MD, CCN 215029 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2023
May 1, 2023
Heartland Hospice (Beltsville)Beltsville, MD, CCN 211542 Hospice Contracted Managing Employee Nov 1, 2023

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1407059413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626C ADMIRAL DR",
            "address_2": "# 235",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012151",
            "telephone_number": "301-352-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 MEDICAL CENTER DR # 3230-F",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207743701",
            "telephone_number": "301-352-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAKOLI-JALILI",
        "first_name": "NADER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2021-08-27",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MD",
            "license": "D0041978",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0041978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305791700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROV #",
            "identifier": "B181",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NADER",
            "last_name": "TAVAKOLI",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Largo, MD

Sources for this page

Verify at the official NPI Registry.