Johns Hopkins Bayview Medical Center, Inc.

Key facts

NPI: 1003972530
Entity type: Organization (NPI type 2)
Primary specialty: Clinic Pharmacy 3336C0002X
License: P02057 (MD)
Legal business name: JOHNS HOPKINS BAYVIEW MEDICAL CENTER, INC.
Practice address: 4940 Eastern Ave
Bmo Building, Room 01-0154
Baltimore, MD 21224-2735
Phone: (410) 550-0961
Fax: (410) 550-5566
NPI assigned: Dec 29, 2006
Organization subpart: No

Authorized official

Name: Mr. Carl Henry Francioli
Title: Vice President of Finance
Phone: (410) 955-6552

Other NPIs with the same Medicare PAC ID 1

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

Johns Hopkins Bayview Medical Center Inc General Acute Care Hospital · Baltimore, MD · NPI 1790700904

Same PAC ID 7012982051

Practitioners 1

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

Brian Ferullo, PHARMD Pharmacist · Baltimore, MD · NPI 1407244734

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MD

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20110831000103	MD	Part B Supplier - Mass Immunization (Roster Biller Only)	7012982051	Practice locations: Baltimore, MD

National Provider Directory

Locations

4940 Eastern Ave
Rm 10154
Baltimore, MD 21224
Phone (410) 288-8000

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinic Pharmacy	3336C0002X	P02057	MD	Yes
Community/Retail Pharmacy	3336C0003X	P02057	MD

Addresses

Primary practice location

4940 Eastern Ave
Bmo Building, Room 01-0154
Baltimore, MD 21224-2735

Mailing address

PO Box 418854
Boston, MA 02241-8854
Phone (443) 997-0001

Other identifiers

Identifier	Type	State	Issuer
2112934	Other	MD	NCPDP
4125355 00	Medicaid	MD
4131509 00	Medicaid	MD

Other names

Johns Hopkins Outpatient Pharmacy at Bayview Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 17, 2017.

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494979200000",
    "number": "1003972530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 418854",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022418854",
            "telephone_number": "443-997-0001",
            "fax_number": "443-997-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVE",
            "address_2": "BMO BUILDING, ROOM 01-0154",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242735",
            "telephone_number": "410-550-0961",
            "fax_number": "410-550-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNS HOPKINS BAYVIEW MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2017-05-17",
        "status": "A",
        "authorized_official_last_name": "FRANCIOLI",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "410-955-6552",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "MD",
            "license": "P02057",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P02057",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2112934",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4125355 00",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4131509 00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johns Hopkins Outpatient Pharmacy at Bayview",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

All providers in Baltimore, MD · Clinic Pharmacy in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2017. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.