| Premier Primary Care LLC | |
|
3546 Worthington Blvd Unit 301 Frederick MD 21704-7126 | |
| (301) 979-9772 | |
| (301) 355-0076 |
| Full Name | Premier Primary Care LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 3546 Worthington Blvd Unit 301, Frederick, Maryland |
| Authorized Official Name and Position | Sassan Taghizadehmoghaddam (CFO/MEMBER) |
| Authorized Official Contact | 2022694770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Primary Care LLC Po Box 34202 Bethesda MD 20827-0202 Ph: (301) 979-9772 | Premier Primary Care LLC 3546 Worthington Blvd Unit 301 Frederick MD 21704-7126 Ph: (301) 979-9772 |
| NPI Number | 1568275600 |
|---|---|
| Provider Enumeration Date | 01/31/2025 |
| Last Update Date | 03/26/2025 |
| Certification Date | 03/26/2025 |
| Medicare PECOS PAC ID | 3476068354 |
|---|---|
| Medicare Enrollment ID | O20250711001206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568275600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Mahboobeh Memarsadeghi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336554468 PECOS PAC ID: 5193071934 Enrollment ID: I20181101001955 |
| Provider Name | Sassan Taghizadehmoghaddam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992722557 PECOS PAC ID: 4385746635 Enrollment ID: I20250711001695 |
| Provider Name | Kimia Ghaznavi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841547106 PECOS PAC ID: 0749599199 Enrollment ID: I20250712000034 |
| Provider Name | Jagmeet Kaur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114296787 PECOS PAC ID: 6204055874 Enrollment ID: I20250714003769 |
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