DR. KHODADAD MODJTABAI M.D. NPI 1578567913

NPI Information

  • NPI: 1578567913
  • Provider Name: DR. KHODADAD MODJTABAI, M.D.
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 10802 HICKORY RIDGE RD
    COLUMBIA, MD
    ZIP 21044
  • Phone: (301) 997-1336

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NPI Details

DR. Khodadad Modjtabai, M.D. is a specialist in Columbia, MD with 27 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Khodadad Modjtabai, M.D. NPI is 1578567913. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10802 HICKORY RIDGE RD
COLUMBIA, MD
ZIP 21044-622
Phone: (301) 997-1336
Fax: (410) 997-1636

The NPI 1578567913 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection, dalbavancin, 5 mg (HCPCS:J0875)
  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Initial hospital inpatient care per day, typically 50 minutes (HCPCS:99222)
  • Critical care, first 30-74 minutes (HCPCS:99291)
  • Follow-up hospital inpatient care per day, typically 15 minutes (HCPCS:99231)
  • Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)
  • Infusion into a vein for therapy, prevention, or diagnosis, each additional hour (HCPCS:96366)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional (HCPCS:99211)
  • Initial hospital inpatient care per day, typically 30 minutes (HCPCS:99221)
  • Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less (HCPCS:96365)
  • Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow (HCPCS:G0181)
  • Initial hospital inpatient care per day, typically 70 minutes (HCPCS:99223)

The enumeration date for this NPI number is 6/13/2005 and was last updated on 10/23/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistDOO61559MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11013399OTHERVIRGINIAFIRST HEALTH
2126480OTHERMARYLANDJOHNS HOPKINS
3410823OTHERMARYLANDAMERICHOICE
45701OTHERMARYLANDELDER HEALTH
5243508OTHERMARYLANDKAISER
6MD0200488OTHERMARYLANDTRICARE
77615905MEDICAIDNORTH CAROLINA
83059165OTHERMARYLANDCIGNA
9I08734MEDICARE UPINMARYLAND
10899M672MMEDICARE ID-TYPE UNSPECIFIEDMARYLANDHOWARD COUNTY
119200455OTHERMARYLANDEVERCARE
12404889000MEDICAIDMARYLAND
131013399OTHERMARYLANDELDER HEALTH
14243208OTHERMARYLANDAMERICAID
155125212OTHERMARYLANDMAMSI
1664167401OTHERMARYLANDBLUE CROSS OF MARYLAND
177305576OTHERMARYLANDAETNA OTHER
182426820OTHERMARYLANDUNITED HEALTHCARE
19N1510002OTHERDISTRICT OF COLUMBIABLUE CROSS FEDERAL
20P00287135OTHERMARYLANDRAILROAD
211142253OTHERMARYLANDAETNA HMO
22243208OTHERMARYLANDAMERIGROUP
235125212OTHERMARYLANDALLIANCE
24036555600MEDICAIDDISTRICT OF COLUMBIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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