NPIMap

Individual provider Active NPI

Ellen Breen Cassidy, MD

  • Family Medicine Physician
  • Millersville, MD
National Provider Identifier
1013982248
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D62595 Issued in MD
Practice address
8601 Veterans Hwy
Ste 204
Millersville, MD 21108-1547
Phone
(410) 553-8092
NPI assigned
Feb 21, 2006
Last updated
Oct 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D62595 MD Primary

Addresses

Primary practice location

8601 Veterans Hwy
Ste 204
Millersville, MD 21108-1547

Mailing address

300 Hospital Dr
Ste 132
Glen Burnie, MD 21061-6902
Phone (410) 787-4594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050624000330 MD Practitioner - Family Practice 3072558535 Reassigns benefits to 2 organizations
I20150514000593 DC Practitioner - Family Practice 3072558535 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curana Health of Maryland LLCGroup PAC ID 5395280549, 21 clinicians
CH Specialty Services MD LLCGroup PAC ID 6002347770, 2 clinicians

Practice addresses (Care Compare)

1840 Reisterstown Rd
Pikesville, MD 21208-1305
Phone (337) 991-9276

7600 Laurel Bowie Rd
Bowie, MD 20715-1075
Phone (337) 991-9276

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mdics Rehabilitative Services LLC Family Medicine CurrentSince May 1, 2015 Accepting new patients
Curana Health of Pennsylvania PC CurrentSince Oct 9, 2024 Accepting new patients
Curana Health of Maryland LLC CurrentSince Oct 9, 2024 Accepting new patients
CH Specialty Services MD LLC CurrentSince Dec 6, 2024 Accepting new patients
35 Milkshake Opco LLC Past Accepting new patients
Choptank Community Health System Inc Past Accepting new patients
Complete Care at Severna Park LLC Past Accepting new patients
Presbyterian Senior Living Services, Inc. Past Accepting new patients

Locations

4907 Rugby Ave
Bethesda, MD 20814
Phone (240) 558-5605

7600 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 317-6576

9211 Stuart Ln
Clinton, MD 20735
Phone (301) 868-3600

6934 Aviation Blvd
Ste B
Glen Burnie, MD 21061
Phone (443) 534-0575

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413331200000",
    "number": "1013982248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL DR",
            "address_2": "STE 132",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210616902",
            "telephone_number": "410-787-4594",
            "fax_number": "410-787-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 VETERANS HWY",
            "address_2": "STE 204",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081547",
            "telephone_number": "410-553-8092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "ELLEN",
        "middle_name": "BREEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2014-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D62595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millersville, MD

Sources for this page

Verify at the official NPI Registry.