Individual provider Active NPI

Sophia Moradi, CRNP

  • Acute Care Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1427595750
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R194076 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-6454
NPI assigned
Jan 24, 2017
Last updated
Mar 23, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R194076 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

22 S Greene St
Baltimore, MD 21201-1544
Phone (410) 328-6454

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170620000610 MD Practitioner - Nurse Practitioner 3577831320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Baltimore Medical CenterGroup PAC ID 1759276975, 350 clinicians

Practice addresses (Care Compare)

3701 N Charles St
South Chapman Building Suite 102
Towson, MD 21204-6808

6535 N Charles St
Baltimore, MD 21204-5822

6565 N Charles St
Baltimore, MD 21204-6808

6569 N Charles St
Suite 505
Baltimore, MD 21204-6808
Phone (443) 849-2658

6569 N Charles St PPW Room
307 GYN Specialists
Baltimore, MD 21204-6808
Phone (443) 849-6123

6569 N Charles Street
504 Hoover Low Vision GBMC
Baltimore, MD 21204-6808
Phone (443) 849-2658

6701 N Charles St
Baltamore, MD 21204-6808

6701 N Charles St BLDG
S Chapman BLDG Suite 102
Baltimore, MD 21204-6808

6701 N Charles St Unit
Baltimore, MD 21204-6808
Phone (443) 849-3131

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R194076MDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Baltimore Medical Center, Inc. CurrentSince May 21, 2019 Accepting new patients
Shock Trauma Associates, P.a. CurrentSince Apr 30, 2017 Accepting new patients
Greater Baltimore Medical Center, Inc Current Accepting new patients
Greater Baltimore Medical Center, Inc. Acute Care CurrentSince May 21, 2019 Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

6535 N Charles St
Ste 125
Towson, MD 21204
Phone (443) 849-3779

6565 N Charles St
Ste 203
Towson, MD 21204
Phone (410) 828-3760

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1427595750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORADI",
        "first_name": "SOPHIA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R194076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.