Individual provider Active NPI

Greg Mark Booth, MD PHD

  • Internal Medicine Physician
  • Hampstead, MD
National Provider Identifier
1063674174
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0077059 Issued in MD
Practice address
4231 N Woods TRL
Hampstead, MD 21074-3128
Phone
(410) 374-9391
Fax
(410) 871-7967
NPI assigned
Jun 30, 2008
Last updated
Aug 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0077059 MD Primary

Addresses

Primary practice location

4231 N Woods TRL
Hampstead, MD 21074-3128

Mailing address

4231 N Woods TRL
Hampstead, MD 21074-3128
Phone (410) 374-9391

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
I20160426000109 MD Practitioner - Internal Medicine 2567761547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians
Lifebridge Primary Care of North Carroll LLCGroup PAC ID 2769709393, 7 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

4231 N Woods TRL
Carroll Medical Group
Hampstead, MD 21074-3128
Phone (410) 374-9391

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.78 of 100Reported as group
Quality
89.6
Promoting interoperability
100
Improvement activities
40
Cost
66.32

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Primary Care of North Carroll, LLC CurrentSince Apr 1, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4231 North Woods Trl
Hampstead, MD 21074
Phone (410) 374-9391

4231 North Woods Trl
Ste 100
Hampstead, MD 21074
Phone (410) 374-9391

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1063674174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4231 N WOODS TRL",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210743128",
            "telephone_number": "410-374-9391",
            "fax_number": "410-871-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4231 N WOODS TRL",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210743128",
            "telephone_number": "410-374-9391",
            "fax_number": "410-871-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "GREG",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0077059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampstead, MD

Sources for this page

Verify at the official NPI Registry.