Active NPI
Bernard R Abbott, MD
- Pediatrics Physician
- Baltimore, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- D0029508
- Practice address
- 2449 Frederick Ave
Baltimore, MD 21223-2856 - Phone
- (410) 383-8300
- Fax
- (410) 383-3160
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | D0029508 | MD | Primary |
Addresses
Primary practice location
2449 Frederick Ave
Baltimore, MD 21223-2856
Mailing address
2449 Frederick Ave
Baltimore, MD 21223-2856
Phone (410) 383-8300
Other practice location 1
1215 Annapolis Rd
Odenton, MD 21113-1344
Phone (410) 383-8300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 030951600 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180808002534 | MD | Practitioner - Pediatric Medicine | 4082969019 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Total Health Care Inc. | Current | Accepting new patients | |
| Total Health Care Inc | Current | Accepting new patients | |
| Total Health Care Inc | Current | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Total Health Care Inc | Past | Accepting new patients |
Locations
1501 W Saratoga St
Baltimore, MD 21223
Phone (410) 383-7197
1111 Washington Blvd
Baltimore, MD 21230
Phone (410) 783-1859
1501 Division St
Baltimore, MD 21217
Phone (410) 735-5390
2288 Blue Water Blvd
Ste 440
Odenton, MD 21113
Phone (410) 674-7403
1215 Annapolis Rd
Odenton, MD 21113
Phone (410) 581-5900
Interoperability endpoints
- bernard.abbott.1@7340.direct.athenahealth.com
- https://fhir4.healow.com/fhir/r4/GJFJBD
Organizations & group practices 5
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.
-
- Federally Qualified Health Center (FQHC)
- Baltimore, MD
- NPI 1992889943
-
- Federally Qualified Health Center (FQHC)
- Brooklyn, MD
- NPI 1225857378
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Federally Qualified Health Center (FQHC)
- Baltimore, MD
- NPI 1013902485
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697500800000",
"number": "1063440329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2449 FREDERICK AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212232856",
"telephone_number": "410-383-8300",
"fax_number": "410-383-3160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2449 FREDERICK AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212232856",
"telephone_number": "410-383-8300",
"fax_number": "410-383-3160"
}
],
"practiceLocations": [
{
"address_1": "1215 Annapolis Rd",
"address_purpose": "LOCATION",
"city": "Odenton",
"state": "MD",
"postal_code": "211131344",
"country_code": "US",
"telephone_number": "410-383-8300",
"fax_number": "410-383-3160",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ABBOTT",
"first_name": "BERNARD",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2023-10-17",
"certification_date": "2023-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "D0029508",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "030951600",
"state": "MD"
}
],
"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 Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.