Individual provider Active NPI

Cyrus Nemati, M.D.

  • Nephrology Physician
  • Temple Hills, MD
National Provider Identifier
1538278460
Registry record updated Dec 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
D25725 Issued in MD
Practice address
3611 Branch Ave
Suite 407
Temple Hills, MD 20748-1242
Phone
(301) 899-3388
Fax
(301) 899-3309
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X D25725 MD Primary

Addresses

Primary practice location

3611 Branch Ave
Suite 407
Temple Hills, MD 20748-1242

Mailing address

12441 Bacall LN
Potomac, MD 20854-1026
Phone (301) 590-9797

Other identifiers 2

IdentifierTypeStateIssuer
788091000MedicaidMD
010890700MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20110607000573 DC Practitioner - NephrologyPractitioner - Internal Medicine 5597942136 Practice locations: Temple Hills, MD

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261353600000",
    "number": "1538278460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12441 BACALL LN",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208541026",
            "telephone_number": "301-590-9797",
            "fax_number": "301-899-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 BRANCH AVE",
            "address_2": "SUITE 407",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207481242",
            "telephone_number": "301-899-3388",
            "fax_number": "301-899-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMATI",
        "first_name": "CYRUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": "D25725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "788091000",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010890700",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Hills, MD

Sources for this page

Verify at the official NPI Registry.