NPIMap

Organization Active NPI

Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Halethorpe, MD
National Provider Identifier
1043378656
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Practice address
Kaiser Permanente-South Baltimore
1701 Twin Springs Road
Halethorpe, MD 21227-3553
Phone
(410) 737-5000
Fax
(443) 263-7381
NPI assigned
Dec 5, 2006
Reactivated
Dec 20, 2024
Last updated
Jul 24, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Colleen E Swinton
Title
Director,Credentialing/Provider Enr
Phone
(301) 257-2797

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary
Psychologist 103T00000X
Nutritionist 133N00000X
Pediatric Registered Nurse 163WP0200X
Allergy & Immunology Physician 207K00000X
Endocrinology, Diabetes & Metabolism Physician 207RE0101X
Gastroenterology Physician 207RG0100X
Pulmonary Disease Physician 207RP1001X
Obstetrics & Gynecology Physician 207V00000X
Plastic Surgery Physician 208200000X
Diagnostic Radiology Physician 2085R0202X

Addresses

Primary practice location

Kaiser Permanente-South Baltimore
1701 Twin Springs Road
Halethorpe, MD 21227-3553

Mailing address

4000 Garden City Drive
4TH Floor Ppqa
Hyattsville, MD 20785-2418
Phone (301) 816-2424

Other identifiers 1

IdentifierTypeStateIssuer
K679OtherMDMEDICARE GROUP ID

Other names 1

  • Kaiser Permanente Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080519000558 MD Part B Supplier - Clinic/Group Practice 3779495858 Receives reassigned benefits from 1,282 practitioners
4 other NPIs on this enrollment
Practice locations: Timonium, MD; Nottingham, MD; Halethorpe, MD; Glen Burnie, MD; Frederick, MD; Baltimore, MD; Annapolis, MD; Abingdon, MD…

Other NPIs with the same Medicare PAC ID 16

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

View all 16

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Kaiser FDTN Health Plan M a

Locations

7670 Quarterfield Rd
Ofc
Glen Burnie, MD 21061
Phone (410) 508-7650

Practitioners & affiliated clinicians

Practitioners 1,296

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 1,296

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1043378656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 GARDEN CITY DRIVE",
            "address_2": "4TH FLOOR PPQA",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207852418",
            "telephone_number": "301-816-2424",
            "fax_number": "301-816-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KAISER PERMANENTE-SOUTH BALTIMORE",
            "address_2": "1701 TWIN SPRINGS ROAD",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "212273553",
            "telephone_number": "410-737-5000",
            "fax_number": "443-263-7381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC",
        "enumeration_date": "2006-12-05",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "deactivation_date": "2024-12-02",
        "reactivation_date": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "SWINTON",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR,CREDENTIALING/PROVIDER ENR",
        "authorized_official_telephone_number": "301-257-2797"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP  ID",
            "identifier": "K679",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6104 Old Branch Ave",
            "city": "Temple Hills",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207482518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaiser Permanente",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Halethorpe, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare 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.