Musa Musa Mivanyi

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D0097898 Issued in MD

Practice address

4340 Park Heights Ave
Baltimore, MD 21215-6725

Phone

(410) 542-8130

NPI assigned

May 29, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Park Heights Medical Clinic LLC

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1639101462
  Medicare reassignment NPD
• Hollis Seunarine Mdpa LLC

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1891726378
  NPD (past)

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1821612466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 PARK HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212156725",
            "telephone_number": "410-542-8130",
            "fax_number": "410-542-1826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 PARK HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212156725",
            "telephone_number": "410-542-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIVANYI",
        "first_name": "MUSA",
        "middle_name": "MUSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-29",
        "last_updated": "2023-12-18",
        "certification_date": "2023-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0097898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shashank Mittal, PT
• Asha Rani Mittar, MD
• Jo-Ann H Mittelman, CRNP
• Nanhi Mitter, M.D.
• Scott Harvey Mittman, M.D., PH.D.
• Monica Mix, M.D.
• Sara Mixter, M.D.
• Shahida Binti Mizan, MD
• Shannon Mize
• Alix Mizoue, MD

• Pediatrics Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.