NPIMap

Organization Active NPI

Optum Medical Services of California, PC

  • Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1023484177
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
OPTUM MEDICAL SERVICES OF CALIFORNIA, PC
Practice address
351 W Camden St
Suite 100
Baltimore, MD 21201-7912
Phone
(410) 625-2200
NPI assigned
Aug 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Authorized official

Name
Ronald Shumacher, MD
Title
Director
Phone
(240) 683-5331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

351 W Camden St
Suite 100
Baltimore, MD 21201-7912

Mailing address

351 W Camden St
Suite 100
Baltimore, MD 21201-7912

National Provider Directory

National Provider Directory
Tax ID family
Optum Medical Services of California2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

351 W Camden St
Ste 100
Baltimore, MD 21201
Phone (410) 625-2200

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439337600000",
    "number": "1023484177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 W CAMDEN ST",
            "address_2": "SUITE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212017912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 W CAMDEN ST",
            "address_2": "SUITE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212017912",
            "telephone_number": "410-625-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM MEDICAL SERVICES OF CALIFORNIA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A",
        "authorized_official_last_name": "SHUMACHER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "240-683-5331",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.