Individual provider Active NPI

Nina Kashtelyan, M.D.

  • Pediatric Adolescent Medicine Physician
  • Baltimore, MD
National Provider Identifier
1629038518
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
D55037 Issued in MD
Practice address
4000 Old Court Rd
Suite 205
Baltimore, MD 21208-2800
Phone
(410) 484-9950
Fax
(410) 484-9953
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X D55037 MD Primary

Addresses

Primary practice location

4000 Old Court Rd
Suite 205
Baltimore, MD 21208-2800

Mailing address

4000 Old Court Rd
Suite 205
Baltimore, MD 21208-2800
Phone (410) 484-9950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D55037MDMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nina Kashtelyan P.C. CurrentSince Oct 13, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4000 Old Court Rd
Ste 205
Pikesville, MD 21208
Phone (410) 484-9950

Interoperability endpoints

  • Direct secure messaging: nkashtelyan@794.securemail.prognocis.com

Organizations & group practices 2

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629038518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 OLD COURT RD",
            "address_2": "SUITE 205",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212082800",
            "telephone_number": "410-484-9950",
            "fax_number": "410-484-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 OLD COURT RD",
            "address_2": "SUITE 205",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212082800",
            "telephone_number": "410-484-9950",
            "fax_number": "410-484-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASHTELYAN",
        "first_name": "NINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MD",
            "license": "D55037",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.