Individual provider Active NPI

Imtiaz H Chowdhry, M.D.

  • Specialist
  • Columbia, MD
National Provider Identifier
1699741439
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0028921 Issued in MD
Practice address
10792 Hickory Ridge Rd
Columbia, MD 21044-3646
Phone
(410) 964-3611
Fax
(410) 992-4669
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D0028921 MD Primary

Addresses

Primary practice location

10792 Hickory Ridge Rd
Columbia, MD 21044-3646

Mailing address

10792 Hickory Ridge Rd
Columbia, MD 21044-3646
Phone (410) 964-3611

Other identifiers 5

IdentifierTypeStateIssuer
24118OtherMDMAMSI
02311400MedicaidMD
525085OtherMDAETNA
8876OtherMDFED BS
306870-01OtherMDBLUE SHIELD

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
I20091216000138 MD Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Nuclear Medicine 6204975337 Reassigns benefits to 1 organization
Practice locations: Columbia, MD

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0028921MDMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Padder Health Services, LLC CurrentSince Aug 1, 2019 Accepting new patients
Padder Health Services, LLC CurrentSince Aug 1, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

8850 Columbia 100 Pkwy
Ste 308
Columbia, MD 21045
Phone (301) 560-4747

10792 Hickory Ridge Rd
Columbia, MD 21044
Phone (410) 600-3737

7350 Van Dusen Rd
Ste 130
Laurel, MD 20707
Phone (301) 498-8880

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AFEBAA

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.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1699741439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10792 HICKORY RIDGE RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443646",
            "telephone_number": "410-964-3611",
            "fax_number": "410-992-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10792 HICKORY RIDGE RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443646",
            "telephone_number": "410-964-3611",
            "fax_number": "410-992-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOWDHRY",
        "first_name": "IMTIAZ",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0028921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "24118",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02311400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "525085",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED BS",
            "identifier": "8876",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "306870-01",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.