Individual provider Active NPI

Keyvan Rafei, MD

  • Pediatrics Physician
  • Columbia, MD
National Provider Identifier
1669417267
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D58619 Issued in MD
Practice address
10380 Old Columbia Rd Ste 100
Columbia, MD 21046-2005
Phone
(443) 492-4000
Fax
(443) 492-4010
NPI assigned
Jun 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D58619 MD Primary

Addresses

Primary practice location

10380 Old Columbia Rd Ste 100
Columbia, MD 21046-2005

Mailing address

10380 Old Columbia Rd Ste 100
Columbia, MD 21046-2005
Phone (405) 060-7392

Other identifiers 2

IdentifierTypeStateIssuer
022004300MedicaidMD
400788300MedicaidMD

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blossoming Minds Pediatrics Current Accepting new patients
Blossoming Minds Pediatrics Pediatrics CurrentSince Dec 6, 2022 Accepting new patients
Union Memorial Hospital Past Accepting new patients
Johns Hopkins Emergency Medical Past Accepting new patients

Locations

10380 Old Columbia Rd
Ste 100
Columbia, MD 21046
Phone (443) 492-4000

13994 Baltimore Ave
Ste 101
Laurel, MD 20707
Phone (240) 636-9849

Organizations & group practices 4

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1669417267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10380 OLD COLUMBIA RD STE 100",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462005",
            "telephone_number": "405-060-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10380 OLD COLUMBIA RD STE 100",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462005",
            "telephone_number": "443-492-4000",
            "fax_number": "443-492-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFEI",
        "first_name": "KEYVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D58619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022004300",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400788300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.