Individual provider Active NPI

Reza Alavi, M.D., MHS, MBA

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1790958692
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D67215 Issued in MD
Practice address
933 N Wolfe St
Baltimore, MD 21205-1113
Phone
(410) 502-3469
Fax
(410) 502-7387
NPI assigned
Apr 11, 2008
Last updated
Sep 30, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D67215 MD Primary

Addresses

Primary practice location

933 N Wolfe St
Baltimore, MD 21205-1113

Mailing address

933 N Wolfe St
Baltimore, MD 21205-1113
Phone (410) 502-3469

Other identifiers 1

IdentifierTypeStateIssuer
018870100MedicaidMD

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
I20081001000623 MD Practitioner - Internal Medicine 7315015575 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D67215MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alavi Medical Services, P.C. Current Accepting new patients

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, 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": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1790958692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051113",
            "telephone_number": "410-502-3469",
            "fax_number": "410-502-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051113",
            "telephone_number": "410-502-3469",
            "fax_number": "410-502-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAVI",
        "first_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "M.D., MHS, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-11",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D67215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018870100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.