Individual provider Active NPI

Ali Tabatabai, MD

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1639204753
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D66267 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-6704
Fax
(410) 328-4124
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X D66267 MD
Internal Medicine Physician 207R00000X D66267 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

PO Box 64793
Baltimore, MD 21264-4793
Phone (410) 328-6704

Other identifiers 1

IdentifierTypeStateIssuer
412785400MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20070817000367 MD Practitioner - Internal MedicinePractitioner - General SurgeryPractitioner - Critical Care (Intensivists) 5395837520 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists)
Education
University of Maryland School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7601 Osler Dr
Towson, MD 21204-7700
Phone (410) 337-4877

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.09 of 100Reported as group
Quality
79.06
Promoting interoperability
100
Improvement activities
40
Cost
77.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D66267MDMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Feb 6, 2023 Accepting new patients
Shock Trauma Associates, P.a. CurrentSince Jul 1, 2009 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Feb 6, 2023 Accepting new patients

Locations

110 S Paca St
#38
Baltimore, MD 21201

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

Interoperability endpoints

  • Direct secure messaging: atabatabai6507@direct.umm.edu

Organizations & group practices 3

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 1

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1639204753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64793",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644793",
            "telephone_number": "410-328-6704",
            "fax_number": "410-328-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6704",
            "fax_number": "410-328-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABATABAI",
        "first_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MD",
            "license": "D66267",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D66267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "412785400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.