NPIMap

Organization Active NPI

Massumi Rehabilitation & Pain Medicine, LLC

  • Medical Specialty Clinic/Center
  • Towson, MD
National Provider Identifier
1629489117
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
D0032831 Issued in MD
Legal business name
MASSUMI REHABILITATION & PAIN MEDICINE, LLC
Practice address
660 Kenilworth Dr
Suite 200
Towson, MD 21204-2313
Phone
(410) 825-5905
Fax
(410) 825-7712
NPI assigned
May 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Authorized official

Name
Dr. Mehrdad Michael Massumi, M.D.NPI 1407894975
Title
President/Owner
Phone
(410) 825-5905

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X D0032831 MD Primary

Addresses

Primary practice location

660 Kenilworth Dr
Suite 200
Towson, MD 21204-2313

Mailing address

660 Kenilworth Dr
Suite 200
Towson, MD 21204-2313
Phone (410) 825-5905

Other identifiers 2

IdentifierTypeStateIssuer
426194OtherCOVENTRY
091911000MedicaidMD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400457600000",
    "number": "1629489117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 KENILWORTH DR",
            "address_2": "SUITE 200",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042313",
            "telephone_number": "410-825-5905",
            "fax_number": "410-825-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 KENILWORTH DR",
            "address_2": "SUITE 200",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042313",
            "telephone_number": "410-825-5905",
            "fax_number": "410-825-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSUMI REHABILITATION & PAIN MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-05-19",
        "status": "A",
        "authorized_official_last_name": "MASSUMI",
        "authorized_official_first_name": "MEHRDAD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "410-825-5905",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MD",
            "license": "D0032831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "426194",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091911000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; 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.