Individual provider Active NPI

Bernard R Abbott, MD

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1063440329
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0029508 Issued in MD
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

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
030951600MedicaidMD

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

OrganizationSpecialtyStatusNew patients
Total Health Care Inc. CurrentSince Oct 28, 2023 Accepting new patients
Total Health Care Inc CurrentSince Oct 28, 2023 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

  • Direct secure messaging: bernard.abbott.1@7340.direct.athenahealth.com
  • FHIR API: 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.

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

Verify at the official NPI Registry.