NPIMap

Organization Active NPI

Greater Baltimore Medical Center, Inc.

  • Ophthalmology Physician
  • Baltimore, MD
National Provider Identifier
1053471920
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
GREATER BALTIMORE MEDICAL CENTER, INC.
Practice address
6569 N Charles St
Suite 305
Baltimore, MD 21204-6831
Phone
(443) 849-2658
NPI assigned
Dec 11, 2006
Organization subpart
Yes
Parent organization
GREATER BALTIMORE MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Authorized official

Name
Mr. Laurie Beyer
Title
Executive Vice President & Cfo
Phone
(443) 849-2519

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

6569 N Charles St
Suite 305
Baltimore, MD 21204-6831

Mailing address

PO Box 631568
Baltimore, MD 21263-1568

Other identifiers 3

IdentifierTypeStateIssuer
547461200MedicaidMD
S141OtherMDCAREFIRST REGIONAL
K254GBOtherMDCAREFIRST MARYLAND

Other names 1

  • GBMC Inc-Hoover Low Vision Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000852 MD Part B Supplier - Clinic/Group Practice 1759276975 Receives reassigned benefits from 513 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
GB Head and Neck Assoc

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1053471920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631568",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212631568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6569 N CHARLES ST",
            "address_2": "SUITE 305",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046831",
            "telephone_number": "443-849-2658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER BALTIMORE MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREATER BALTIMORE MEDICAL CENTER, INC.",
        "enumeration_date": "2006-12-11",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "BEYER",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "443-849-2519",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "547461200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST REGIONAL",
            "identifier": "S141",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MARYLAND",
            "identifier": "K254GB",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GBMC Inc-Hoover Low Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GBMC Inc-Hoover Low Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 5, 2023; 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.