Individual provider Active NPI

Ambroise Wonkam, MD, PHD

  • Clinical Genetics (M.D.) Physician
  • Baltimore, MD
National Provider Identifier
1093416349
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
D0048440 Issued in MD
Practice address
773 N. Broadway
MRB 439
Baltimore, MD 21205
Phone
(443) 287-0245
NPI assigned
Mar 14, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207SG0201X D0048440 MD Primary

Addresses

Primary practice location

773 N. Broadway
MRB 439
Baltimore, MD 21205

Mailing address

10186 Maxine St
Ellicott City, MD 21042-6317
Phone (410) 259-4441

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
I20230526002018 MD Practitioner - Pediatric Medicine 4789041203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Group practices
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

600 N Wolf St
Baltimore, MD 21287-0005
Phone (410) 955-5000

600 N Wolfe St
Blalock 266
Baltimore, MD 21287-0005
Phone (410) 502-4340

601 N Caroline St
Baltimore, MD 21287-0006
Phone (410) 955-5080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0048440MDMDClinical Genetics (M.D.) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Single Specialty Current Accepting new patients
Johns Hopkins University CurrentSince Apr 12, 2023 Accepting new patients
Johns Hopkins University Clinical Genetics (M.D.) CurrentSince Apr 12, 2023 Accepting new patients

Locations

601 N Caroline St
Baltimore, MD 21287
Phone (410) 955-5080

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

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 and National Provider Directory roles.

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": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1093416349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10186 MAXINE ST",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210426317",
            "telephone_number": "410-259-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "773 N. BROADWAY",
            "address_2": "MRB 439",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21205",
            "telephone_number": "443-287-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONKAM",
        "first_name": "AMBROISE",
        "name_prefix": "Prof.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "MD",
            "license": "D0048440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.