Individual provider Active NPI

Tamima Hossain, D.O.

  • Pediatrics Physician
  • Clarksburg, MD
National Provider Identifier
1699339929
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
H0098904 Issued in MD
Practice address
23218 Brewers Tavern Way
Clarksburg, MD 20871-4391
Phone
(301) 528-8181
Fax
(301) 528-8282
NPI assigned
Apr 22, 2019
Last updated
Apr 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 102207224 VA
Pediatrics Physician 208000000X H0098904 MD Primary

Addresses

Primary practice location

23218 Brewers Tavern Way
Clarksburg, MD 20871-4391

Mailing address

23218 Brewers Tavern Way
Clarksburg, MD 20871-4391
Phone (301) 528-8181

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address thossain289733@direct.vidanthealth.com
Direct Messaging Address info@clarksburgpediatrics.com Clarksburg Pediatrics, L.L.C.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190712001566 NC Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6204161284

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H0098904MDMDPediatrics Physician
102207224VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trusted Doctors LLC Pediatrics PastSince Jul 17, 2022 Accepting new patients
Clarksburg Pediatrics, L.L.C. Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tamima.hossain@bp1.eclinicaldirectplus.com
  • Direct secure messaging: thossain289733@direct.vidanthealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1699339929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23218 BREWERS TAVERN WAY",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208714391",
            "telephone_number": "301-528-8181",
            "fax_number": "301-528-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23218 BREWERS TAVERN WAY",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208714391",
            "telephone_number": "301-528-8181",
            "fax_number": "301-528-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSSAIN",
        "first_name": "TAMIMA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "102207224",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "H0098904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thossain289733@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@clarksburgpediatrics.com",
            "affiliation": "Y",
            "affiliationName": "Clarksburg Pediatrics, L.L.C.",
            "address_1": "23218 Brewers Tavern Way",
            "city": "Clarksburg",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208714391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clarksburg, MD

Sources for this page

Verify at the official NPI Registry.