Individual provider Active NPI

Maryam Z Moghaddam

  • Student in an Organized Health Care Education/Training Program
  • Pittsburgh, PA
National Provider Identifier
1427625045
Registry record updated Sep 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3501 Terrace St
G-32 Salk Hall
Pittsburgh, PA 15261
Phone
(412) 618-8604
NPI assigned
Jun 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS043248 PA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3501 Terrace St
G-32 Salk Hall
Pittsburgh, PA 15261

Mailing address

3600 Forbes Avenue
Forbes Tower - Plaza Level Suite 140
Pittsburgh, PA 15213

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address UPMChospitals@upmcdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210726001182 PA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0143623397

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: maryam.moghaddam@upmcdirect.com

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632009600000",
    "number": "1427625045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FORBES AVENUE",
            "address_2": "FORBES TOWER - PLAZA LEVEL SUITE 140",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 TERRACE ST",
            "address_2": "G-32 SALK HALL",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15261",
            "telephone_number": "412-618-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHADDAM",
        "first_name": "MARYAM",
        "middle_name": "Z",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-09-19",
        "certification_date": "2021-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS043248",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UPMChospitals@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St Fl 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.