NPIMap

Organization Active NPI

Maiden Choice Nuclear Imaging Center

  • Nuclear Radiology Physician
  • Baltimore, MD
National Provider Identifier
1528022480
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Radiology PhysicianTaxonomy code 2085N0904X
License
MD0512101 Issued in MD
Legal business name
MAIDEN CHOICE NUCLEAR IMAGING CENTER
Practice address
724 Maiden Choice LN
Suite 202
Baltimore, MD 21228-5911
Phone
(410) 747-3300
Fax
(410) 455-0009
NPI assigned
Apr 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Authorized official

Name
Homayoon Moghbeli, MDNPI 1235118381
Title
President of Board
Phone
(410) 747-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085N0904X MD0512101 MD Primary

Addresses

Primary practice location

724 Maiden Choice LN
Suite 202
Baltimore, MD 21228-5911

Mailing address

724 Maiden Choice LN
Suite 202
Baltimore, MD 21228-5911
Phone (410) 747-3300

Other identifiers 1

IdentifierTypeStateIssuer
265080100MedicaidMD

Other names 1

  • St Agnes Nuclear Imaging Former legal business name

National Provider Directory

National Provider Directory

Locations

724 Maiden Choice Ln
Ste 202
Catonsville, MD 21228
Phone (410) 455-0200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248739200000",
    "number": "1528022480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 MAIDEN CHOICE LN",
            "address_2": "SUITE 202",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212285911",
            "telephone_number": "410-747-3300",
            "fax_number": "410-455-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 MAIDEN CHOICE LN",
            "address_2": "SUITE 202",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212285911",
            "telephone_number": "410-747-3300",
            "fax_number": "410-455-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIDEN CHOICE NUCLEAR IMAGING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-17",
        "last_updated": "2009-07-28",
        "status": "A",
        "authorized_official_last_name": "MOGHBELI",
        "authorized_official_first_name": "HOMAYOON",
        "authorized_official_title_or_position": "PRESIDENT OF BOARD",
        "authorized_official_telephone_number": "410-747-3300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Nuclear Radiology",
            "state": "MD",
            "license": "MD0512101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265080100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Agnes Nuclear Imaging",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.