Individual provider Active NPI

Nima Khavanin

  • Plastic Surgery Physician
  • Baltimore, MD
National Provider Identifier
1770973190
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD500003365 Issued in DC
Practice address
4940 Eastern Ave
Suite A518
Baltimore, MD 21224-2735
Phone
(410) 550-0407
NPI assigned
Jan 24, 2015
Last updated
Jul 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X D0100771 MD
Plastic Surgery Physician 208200000X MD500003365 DC Primary

Addresses

Primary practice location

4940 Eastern Ave
Suite A518
Baltimore, MD 21224-2735

Mailing address

6201 Greenleigh Ave FL 2
Middle River, MD 21220-2004
Phone (410) 933-2704

Other practice location 1

5255 Loughboro Rd NW
Washington, DC 20016-2633
Phone (202) 537-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240731001840 DC Practitioner - Plastic and Reconstructive Surgery 9335497593 Reassigns benefits to 1 organization
I20240731002092 MD Practitioner - Plastic and Reconstructive SurgeryPractitioner - Ophthalmology 9335497593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Northwestern University Feinberg Medical School, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Johns Hopkins UniversityGroup PAC ID 1052223229, 196 clinicians
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

5215 Loughboro Rd NW
Suite 150
Washington, DC 20016-2622
Phone (844) 546-5645

5255 Loughboro Rd NW
Sibley Memorial Hospital
Washington, DC 20016-2633
Phone (202) 660-6500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy17
Melanoma (skin cancer) excision18
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Plastic Surgery CurrentSince Jul 1, 2024 Accepting new patients
Johns Hopkins University CurrentSince Jul 1, 2024 Accepting new patients
Johns Hopkins University CurrentSince Jul 1, 2024 Accepting new patients
Johns Hopkins University Current Accepting new patients

Locations

5215 Loughboro Rd NW
Ste 150
Washington, DC 20016
Phone (202) 895-1440

5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280

4940 Eastern Ave
Ste A518
Baltimore, MD 21224
Phone (410) 550-0407

600 N Wolfe St
Baltimore, MD 21287

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

6201 Greenleigh Ave
Fl 2
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: nkhavanin277306@direct.hopkinsmedicine.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1422057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1770973190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE FL 2",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVE",
            "address_2": "SUITE A518",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242735",
            "telephone_number": "410-550-0407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5255 Loughboro Rd NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200162633",
            "country_code": "US",
            "telephone_number": "202-537-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAVANIN",
        "first_name": "NIMA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-24",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MD",
            "license": "D0100771",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "DC",
            "license": "MD500003365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.