Individual provider Active NPI

Ayesha A Gulistan

  • Internal Medicine Physician
  • Reisterstown, MD
National Provider Identifier
1609105386
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0075367 Issued in MD
Practice address
120 Westminster Pike Ste 104
Reisterstown, MD 21136-1027
Phone
(410) 526-3083
Fax
(410) 584-2240
NPI assigned
Dec 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0075367 MD Primary

Addresses

Primary practice location

120 Westminster Pike Ste 104
Reisterstown, MD 21136-1027

Mailing address

515 Fairmount Ave Ste 400
Towson, MD 21286-8518
Phone (410) 196-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140912000847 MD Practitioner - Internal Medicine 6204083785 Reassigns benefits to 2 organizations
I20160518000070 DC Practitioner - Internal Medicine 6204083785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians
Clinical Associates P aGroup PAC ID 1254631005, 44 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Forest Hill, MD 21050-1758

120 Westminister Pike
Reisterstown, MD 21136-1027
Phone (410) 526-7800

1838 Greene Tree Rd
Pikesville, MD 21208-7108
Phone (443) 471-0460

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Westminster, MD, CCN 217048
  • Homecare Maryland, LLC Home health agency, Owings Mills, MD, CCN 217107
  • Adoration Home Health Baltimore Home health agency, Baltimore, MD, CCN 217134

Merit-based Incentive Payment System (MIPS)

Final score
81.85 of 100Reported as group
Quality
80.72
Promoting interoperability
79
Improvement activities
40
Cost
76.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0075367MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians, Inc Internal Medicine CurrentSince Jul 7, 2014 Accepting new patients
Clinical Associates PA CurrentSince Jan 1, 2022 Accepting new patients
Clinical Associates P a Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Johns Hopkins Community Physicians Internal Medicine CurrentSince Jul 7, 2014 Accepting new patients
Johns Hopkins Community Physicians, Inc Internal Medicine CurrentSince Mar 29, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Clinical Associates P a Past Accepting new patients
Clinical Associates P a Past Accepting new patients

Locations

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

5755 Cedar Ln
Columbia, MD 21044
Phone (410) 381-7171

14207 Park Center Dr
Ste 102
Laurel, MD 20707
Phone (301) 604-5254

9910 Franklin Square Dr
#2110
Nottingham, MD 21236
Phone (410) 933-5412

1838 Greene Tree Rd
Ste 135
Pikesville, MD 21208
Phone (443) 471-0460

120 Westminster Pike
Ste 104
Reisterstown, MD 21136
Phone (410) 526-3083

515 Fairmount Ave
Ste 400
Towson, MD 21286
Phone (410) 494-1324

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: ayesha.gulistan.p2@direct.clinicalassociates.nextgenshare.com

Organizations & group practices 9

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1609105386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 FAIRMOUNT AVE STE 400",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212868518",
            "telephone_number": "410-196-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WESTMINSTER PIKE STE 104",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361027",
            "telephone_number": "410-526-3083",
            "fax_number": "410-584-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULISTAN",
        "first_name": "AYESHA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-09",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0075367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reisterstown, MD

Sources for this page

Verify at the official NPI Registry.