NPIMap

Organization Active NPI

Holy Cross Health, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mitchellville, MD
National Provider Identifier
1073534715
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
E2635 Issued in MD
Legal business name
HOLY CROSS HEALTH, INC.
Practice address
11721 Woodmore Rd
Suite 190
Mitchellville, MD 20721-4117
Phone
(301) 390-7270
NPI assigned
Jul 21, 2006
Last updated
Sep 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Authorized official

Name
Julie Keese
Title
VP & Cfo
Phone
(301) 754-7201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X E2635 MD Primary

Addresses

Primary practice location

11721 Woodmore Rd
Suite 190
Mitchellville, MD 20721-4117

Mailing address

PO Box 531882
Atlanta, GA 30353-1882

Other names 1

  • Holy Cross ESRD Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120706000557 MD Part A Provider - End-Stage Renal Disease Facility (ESRD) 3577473560 Practice locations: Mitchellville, MD

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Holy Cross Dialysis Center - WoodmoreCCN 213503
Overall star rating
2.0 of 5
Ownership
Non-profit
Certified
May 14, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Dialysis stations
15

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
Holy Cross Hosp Lab10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1073534715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 531882",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303531882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11721 WOODMORE RD",
            "address_2": "SUITE 190",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207214117",
            "telephone_number": "301-390-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLY CROSS HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "KEESE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "VP & CFO",
        "authorized_official_telephone_number": "301-754-7201"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MD",
            "license": "E2635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holy Cross ESRD",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Holy Cross ESRD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mitchellville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.