NPIMap

Organization Active NPI

St. Agnes Healthcare, Inc.

Doing business as St Agnes Anesthesia

  • Anesthesiology Physician
  • Baltimore, MD
National Provider Identifier
1003079799
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ST. AGNES HEALTHCARE, INC.
Doing business as
St Agnes Anesthesia
Practice address
900 Caton Ave
Baltimore, MD 21229-5201
Phone
(667) 234-3045
Fax
(410) 951-4009
NPI assigned
Jul 3, 2008
Last updated
Oct 16, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. AGNES HEALTHCARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Mr. William B Higginbotham
Title
President/Ceo
Phone
(667) 234-3162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

900 Caton Ave
Baltimore, MD 21229-5201

Mailing address

3585 Washington Blvd
Halethorpe, MD 21227-1676
Phone (667) 234-2149

Other names 1

  • St Agnes Anesthesia Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080923000209 MD Part B Supplier - Hospital Department(S) 9830092733 Receives reassigned benefits from 64 practitioners
1 other NPI on this enrollment
Practice locations: Baltimore, MD

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
St Agnes HLTH Care41 organizations share this tax ID, including this one
Part of
St Agnes HLTH Care

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

Practitioners & affiliated clinicians

Practitioners 66

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1003079799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 WASHINGTON BLVD",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "212271676",
            "telephone_number": "667-234-2149",
            "fax_number": "667-234-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CATON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295201",
            "telephone_number": "667-234-3045",
            "fax_number": "410-951-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. AGNES HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. AGNES HEALTHCARE, INC.",
        "enumeration_date": "2008-07-03",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "HIGGINBOTHAM",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "667-234-3162",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Agnes Anesthesia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.