Active NPI
Sidney S. Mir, M.D.
- Surgery Physician
- Baltimore, MD
National Provider Identifier
1538411657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- D0019416
- Practice address
- 7905 Ellenham Ave
Baltimore, MD 21204-3523 - Phone
- (410) 583-1566
- NPI assigned
- Oct 12, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | D0019416 | MD | Primary |
Addresses
Primary practice location
7905 Ellenham Ave
Baltimore, MD 21204-3523
Mailing address
7905 Ellenham Ave
Baltimore, MD 21204-3523
Phone (410) 583-1566
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D0019416 | Other | MD | MARYLAND MEDICAL LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0019416 | MD | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350000000000",
"number": "1538411657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7905 ELLENHAM AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212043523",
"telephone_number": "410-583-1566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7905 ELLENHAM AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212043523",
"telephone_number": "410-583-1566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIR",
"first_name": "SIDNEY",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-12",
"last_updated": "2012-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MD",
"license": "D0019416",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARYLAND MEDICAL LICENSE NUMBER",
"identifier": "D0019416",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}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 Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.