Individual provider Active NPI

Niloofar Nasseri-Nik, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Baltimore, MD
National Provider Identifier
1770734337
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
D0071668 Issued in MD
Practice address
401 N Broadway St
Room 2242
Baltimore, MD 21287-0019
Phone
(443) 287-0326
NPI assigned
Oct 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X D0071668 MD Primary

Addresses

Primary practice location

401 N Broadway St
Room 2242
Baltimore, MD 21287-0019

Mailing address

PO Box 64478
Baltimore, MD 21264-4478
Phone (410) 955-3580

Other identifiers 1

IdentifierTypeStateIssuer
21264-4478MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20130827000654 FL Practitioner - Pathology 4981872363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Associates of South MiamiGroup PAC ID 6901901123, 5 clinicians

Practice addresses (Care Compare)

6200 SW 73 St
Miami, FL 33143-4679
Phone (786) 662-8168

Hospital & facility affiliations

  • South Miami Hospital Hospital, Miami, FL, CCN 100154
  • Baptist Hospital of Miami Hospital, Miami, FL, CCN 100008
  • Univ of Miami Hospital and Clinics-Sylvester Compr Hospital, Miami, FL, CCN 100079

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0071668MDMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates of South Miami Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 2013 Accepting new patients

Locations

6200 SW 73rd St
South Miami, FL 33143
Phone (305) 661-4611

Organizations & group practices 1

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 3

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": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362096000000",
    "number": "1770734337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64478",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644478",
            "telephone_number": "410-955-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N BROADWAY ST",
            "address_2": "ROOM 2242",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870019",
            "telephone_number": "443-287-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSERI-NIK",
        "first_name": "NILOOFAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2013-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MD",
            "license": "D0071668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21264-4478",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.