NPIMap

Individual provider Active NPI

Marisa Flavin, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Baltimore, MD
National Provider Identifier
1033558093
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
D0101188 Issued in MD
Practice address
707 N Broadway
Baltimore, MD 21205-1888
Phone
(443) 923-1842
NPI assigned
Jun 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 256291 MA
Physical Medicine & Rehabilitation Physician 208100000X D0101188 MD Primary
Internal Medicine Physician 207R00000X 256291 MA

Addresses

Primary practice location

707 N Broadway
Baltimore, MD 21205-1888

Mailing address

6201 Greenleigh Ave FL 2
Middle River, MD 21220-2004

Other practice location 1

1800 Orleans St
Baltimore, MD 21287-0010
Phone (410) 955-8893

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mflavin379218@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, MD2 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
I20191028001224 UT Practitioner - Physical Medicine and Rehabilitation 5991004228 Reassigns benefits to 2 organizations
I20241013000052 MD Practitioner - Physical Medicine and Rehabilitation 5991004228 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Virginia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennedy Krieger AssociatesGroup PAC ID 1759280597, 73 clinicians

Practice addresses (Care Compare)

707 N Broadway
Baltimore, MD 21205-1832
Phone (443) 923-9200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0101188MDMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Current Accepting new patients
Kennedy Krieger Associates CurrentSince Aug 12, 2024 Accepting new patients
University of Utah Pediatric Services CurrentSince Aug 25, 2019 Accepting new patients
Johns Hopkins University CurrentSince Oct 1, 2024 Accepting new patients
University of Utah Pediatric Services CurrentSince Aug 25, 2019 Accepting new patients
Johns Hopkins University Physical Medicine & Rehabilitation CurrentSince Oct 1, 2024 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
Kennedy Krieger Associates CurrentSince Aug 12, 2024 Accepting new patients
Shriners Hospitals for Children Physical Medicine & Rehabilitation CurrentSince Aug 29, 2023 Accepting new patients
Shriners Hospitals for Children Past Accepting new patients

Locations

1741 Ashland Ave
Fl 6
Baltimore, MD 21205
Phone (443) 923-1839

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

1800 Orleans St
Baltimore, MD 21287
Phone (410) 502-2037

5501 Hopkins Bayview Cir
Baltimore, MD 21224
Phone (410) 550-0545

6201 Greenleigh Ave
Fl 2
Middle River, MD 21220
Phone (410) 933-2704

1275 E Fairfax Rd
Salt Lake City, UT 84103
Phone (801) 536-3500

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

81 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 662-5700

Interoperability endpoints

  • Direct secure messaging: mflavin1342343@direct.hopkinsmedicine.org
  • Direct secure messaging: mflavin379218@direct.med.utah.edu
  • Direct secure messaging: mflavin43186@direct.kennedykrieger.org

Organizations & group practices 11

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1371859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1033558093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE FL 2",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051888",
            "telephone_number": "443-923-1842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Orleans St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870010",
            "country_code": "US",
            "telephone_number": "410-955-8893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLAVIN",
        "first_name": "MARISA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-22",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "256291",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "D0101188",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "256291",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mflavin379218@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.