Individual provider Active NPI

Massoud Nemati, M.D.

  • Cardiovascular Disease Physician
  • Temple Hills, MD
National Provider Identifier
1568576924
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
D0022305 Issued in MD
Practice address
3611 Branch Ave
Temple Hills, MD 20748-1242
Phone
(301) 899-2100
Fax
(301) 899-3309
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD6873 DC
Cardiovascular Disease Physician 207RC0000X D0022305 MD Primary

Addresses

Primary practice location

3611 Branch Ave
Temple Hills, MD 20748-1242

Mailing address

9929 Bentcross Dr
Potomac, MD 20854-4741
Phone (301) 899-2100

Other identifiers 5

IdentifierTypeStateIssuer
023061700MedicaidDC
521202860OtherMDTAX ID
34412701OtherMDBLUESHEILD
0468OtherDCBLUESHEILD
972231900MedicaidMD

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
I20041202000894 DC Practitioner - Cardiovascular Disease (Cardiology) 5890751739 Practice locations: Temple Hills, MD

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD6873DCMDInternal Medicine Physician
D0022305MDMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1568576924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9929 BENTCROSS DR",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208544741",
            "telephone_number": "301-899-2100",
            "fax_number": "301-899-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 BRANCH AVE",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207481242",
            "telephone_number": "301-899-2100",
            "fax_number": "301-899-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMATI",
        "first_name": "MASSOUD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD6873",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": "D0022305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023061700",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "521202860",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHEILD",
            "identifier": "34412701",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHEILD",
            "identifier": "0468",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "972231900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Hills, MD

Sources for this page

Verify at the official NPI Registry.