Individual provider Active NPI

Mohammad Bourmaf

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1477174266
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0100299 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-8667
NPI assigned
May 3, 2020
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0100299 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) 328-8667

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
I20240723004867 MD Practitioner - Internal Medicine 1052719192 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.13 of 100Reported as group
Quality
56.5
Promoting interoperability
100
Improvement activities
40
Cost
73.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0100299MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Paul Place Specialists, Inc. CurrentSince Jul 11, 2024 Accepting new patients
St Paul Place Specialists Inc CurrentSince Jul 11, 2024 Accepting new patients
Maryland Family Care, Inc. Internal Medicine CurrentSince Jul 11, 2024 Accepting new patients
St. Paul Place Specialists, Inc. Current Accepting new patients

Locations

301 Saint Paul St
Baltimore, MD 21202
Phone (410) 385-4930

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

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.

NPI Registry JSON

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

{
    "created_epoch": "1588464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1477174266",
    "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": "410-328-8667"
        },
        {
            "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": "410-328-8667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURMAF",
        "first_name": "MOHAMMAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-03",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0100299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.