Individual provider Active NPI

Raya Massoud, M.D.

  • Neurology Physician
  • Frederick, MD
National Provider Identifier
1831370063
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
22478 Issued in MD
Practice address
2405 Whittier Dr Unit 100
Frederick, MD 21702-3361
Phone
(301) 799-7588
Fax
(301) 799-7589
NPI assigned
Nov 15, 2007
Last updated
Dec 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Single Specialty Group 193400000X D0080615 MD
Neurology Physician 2084N0400X 22478 MD Primary

Addresses

Primary practice location

2405 Whittier Dr Unit 100
Frederick, MD 21702-3361

Mailing address

8 Bankbarn Cir
Middletown, MD 21769-7734
Phone (443) 710-6009

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
I20160223000766 MD Practitioner - Neurology 1052616422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amber Hill Physical Therapy IncGroup PAC ID 8527963917, 336 clinicians

Practice addresses (Care Compare)

187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503

2405 Whittier Dr
Unit 100
Frederick, MD 21702-3361
Phone (301) 799-7588

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0080615MDMDSingle Specialty Group
22478MDMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Neurology LLC Single Specialty CurrentSince Dec 20, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2405 Whittier Dr
Unit 100
Frederick, MD 21702
Phone (301) 682-2988

Organizations & group practices 3

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 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": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1831370063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 BANKBARN CIR",
            "city": "MIDDLETOWN",
            "state": "MD",
            "postal_code": "217697734",
            "telephone_number": "443-710-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 WHITTIER DR UNIT 100",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217023361",
            "telephone_number": "301-799-7588",
            "fax_number": "301-799-7589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSOUD",
        "first_name": "RAYA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "193400000X",
            "taxonomy_group": "",
            "desc": "Single Specialty",
            "state": "MD",
            "license": "D0080615",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MD",
            "license": "22478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.