NPIMap

Organization Active NPI

Elite Orthopaedic & Musculoskeletal Center, LLC

  • Orthopaedic Surgery Physician
  • Glen Burnie, MD
National Provider Identifier
1962709170
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ELITE ORTHOPAEDIC & MUSCULOSKELETAL CENTER, LLC
Practice address
1413 Madison Park Dr
Glen Burnie, MD 21061-5613
Phone
(410) 691-3571
NPI assigned
Feb 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Authorized official

Name
Dr. Amir MoinfarNPI 1043292279
Title
Managing Director
Phone
(410) 691-3571

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

1413 Madison Park Dr
Glen Burnie, MD 21061-5613

Mailing address

1413 Madison Park Dr
Glen Burnie, MD 21061-5613
Phone (410) 691-3571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110518000082 MD Part B Supplier - Clinic/Group Practice 7315123890 Receives reassigned benefits from 6 practitioners
Practice locations: Glen Burnie, MD

National Provider Directory

National Provider Directory

Locations

1413 Madison Park Dr
Glen Burnie, MD 21061
Phone (410) 691-3571

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADADBA

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1298505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1962709170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 MADISON PARK DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615613",
            "telephone_number": "410-691-3571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 MADISON PARK DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615613",
            "telephone_number": "410-691-3571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE ORTHOPAEDIC & MUSCULOSKELETAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-24",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "MOINFAR",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "410-691-3571",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.