Individual provider Active NPI

Abdolazim Shahsavar, M.D.

  • Psychiatry Physician
  • Baltimore, MD
National Provider Identifier
1598064859
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0078471 Issued in MD
Practice address
6501 N Charles St
Baltimore, MD 21204-6819
Phone
(410) 938-3461
NPI assigned
Mar 24, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X 049548 CT
Psychiatry Physician 2084P0800X D0078471 MD Primary

Addresses

Primary practice location

6501 N Charles St
Baltimore, MD 21204-6819

Mailing address

6501 N Charles St
Baltimore, MD 21204-6819
Phone (410) 938-3461

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
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0078471MDMDPsychiatry Physician
049548CTMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Mental Health Psychiatry 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": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1598064859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046819",
            "telephone_number": "410-938-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046819",
            "telephone_number": "410-938-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHSAVAR",
        "first_name": "ABDOLAZIM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-24",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CT",
            "license": "049548",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0078471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.