Individual provider Active NPI

Carol L Greene, MD

  • Clinical Genetics (M.D.) Physician
  • Baltimore, MD
National Provider Identifier
1003850058
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
D61045 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-3335
Fax
(410) 328-5484
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X D61045 MD Primary
Pediatrics Physician 208000000X D61045 MD

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

PO Box 62063
Baltimore, MD 21264-2063
Phone (410) 706-5181

Other identifiers 1

IdentifierTypeStateIssuer
793004601MedicaidMD

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
I20060104000716 MD Practitioner - Pediatric Medicine 2961425012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 706-5181

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D61045MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Pediatric Associates, PA Pediatrics CurrentSince Aug 4, 2004 Accepting new patients
University of Maryland Pediatrics Assoc PA CurrentSince Aug 4, 2004 Accepting new patients
University of Maryland Pediatric Associates, PA Pediatrics Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

22 S Greene St
Fl 5
Baltimore, MD 21201
Phone (410) 328-5887

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

627 Race St
Cambridge, MD 21613
Phone (410) 228-3223

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

Interoperability endpoints

  • Direct secure messaging: cgreene1328@direct.umm.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1003850058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62063",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212642063",
            "telephone_number": "410-706-5181",
            "fax_number": "410-706-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-3335",
            "fax_number": "410-328-5484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "CAROL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "MD",
            "license": "D61045",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D61045",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "793004601",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.