Organization Active NPI

Maryam Y Mizrahi, MD.P.C.

  • Internal Medicine Physician
  • Rockville, MD
National Provider Identifier
1699965152
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MARYAM Y MIZRAHI, MD.P.C.
Practice address
14800 Physicians LN
Suite 132
Rockville, MD 20850-3940
Phone
(301) 610-5080
Fax
(301) 610-5065
NPI assigned
Jul 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

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

Authorized official

Name
Dr. Maryam Y Mizrahi, M.D.NPI 1225179732
Title
Owner
Phone
(301) 610-5080

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

14800 Physicians LN
Suite 132
Rockville, MD 20850-3940

Mailing address

14800 Physicians LN
Suite 132
Rockville, MD 20850-3940
Phone (301) 610-5080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050729000722 DC Part B Supplier - Clinic/Group Practice 7214965375 Receives reassigned benefits from 1 practitioner
Practice locations: Rockville, MD

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": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307059200000",
    "number": "1699965152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14800 PHYSICIANS LN",
            "address_2": "SUITE 132",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503940",
            "telephone_number": "301-610-5080",
            "fax_number": "301-610-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 PHYSICIANS LN",
            "address_2": "SUITE 132",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503940",
            "telephone_number": "301-610-5080",
            "fax_number": "301-610-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYAM Y MIZRAHI, MD.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2011-06-03",
        "status": "A",
        "authorized_official_last_name": "MIZRAHI",
        "authorized_official_first_name": "MARYAM",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-610-5080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.