Express Medical Wellness LLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

EXPRESS MEDICAL WELLNESS LLC

Practice address

1000 Goodwill Ave
Cambridge, MD 21613-2972

Phone

(443) 203-8898

Fax

(201) 361-5368

NPI assigned

Jul 28, 2023

Last updated

Jan 8, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Neeko Rodriguez

Title

Administrator

Phone

(443) 203-8898

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mesum Moosavi, MD

  • General Practice Physician
  • Hawthorne, NJ
  • NPI 1841630191

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1437830759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 GOODWILL AVE",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216132972",
            "telephone_number": "443-972-4204",
            "fax_number": "201-361-5368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GOODWILL AVE",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216132972",
            "telephone_number": "443-203-8898",
            "fax_number": "201-361-5368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS MEDICAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-28",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "NEEKO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "443-203-8898"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emergency Medicine Associates, PA
• Jeevan Errabolu, M.D.
• Brittany Eskridge
• Dean Evans
• Gina Exantus-Bernard
• Darlene M Fahrman, PD (R.PH)
• Fair Winds Wellness LLC (Fair Winds Wellness)
• Asif Ali Fakhri, M.D.
• Jennifer Farrare, M.ED, LCPC, NCC
• Milton William Feder, M.D.

• Physician Assistant in Cambridge, MD
• Providers in Cambridge, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.