Individual provider Active NPI

Lisa H Bayles, CRNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Berlin, MD
National Provider Identifier
1093704553
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
R060296 Issued in MD
Practice address
10231 Old Ocean City Blvd
Suite 210
Berlin, MD 21811-3568
Phone
(410) 629-6870
Fax
(410) 641-3140
NPI assigned
Oct 18, 2005
Last updated
Oct 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X R060296 MD Primary

Addresses

Primary practice location

10231 Old Ocean City Blvd
Suite 210
Berlin, MD 21811-3568

Mailing address

10026 Old Ocean City Blvd
Building One
Berlin, MD 21811-1288
Phone (410) 641-9450

Other identifiers 1

IdentifierTypeStateIssuer
552105000MedicaidMD

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101115001240 MD Practitioner - Nurse Practitioner 3173718277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.2 of 100Reported as group
Quality
70.92
Promoting interoperability
98
Improvement activities
40
Cost
71.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R060296MDMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic General Hospital Corp CurrentSince Aug 5, 2002 Accepting new patients
Tidalhealth Atlantic, Inc. CurrentSince Aug 5, 2002 Accepting new patients
Atlantic General Hospital Corporation Current Accepting new patients
Atlantic Immedicare LLC Past Accepting new patients

Locations

10026 Old Ocean City Blvd
Ste 1
Berlin, MD 21811

10231 Old Ocean City Blvd
Ste 210
Berlin, MD 21811
Phone (410) 629-6870

9714 Healthway Dr
Berlin, MD 21811
Phone (410) 641-2600

6040 Public Landing Rd
Snow Hill, MD 21863
Phone (410) 629-0041

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1093704553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10026 OLD OCEAN CITY BLVD",
            "address_2": "BUILDING ONE",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111288",
            "telephone_number": "410-641-9450",
            "fax_number": "410-641-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10231 OLD OCEAN CITY BLVD",
            "address_2": "SUITE 210",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113568",
            "telephone_number": "410-629-6870",
            "fax_number": "410-641-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYLES",
        "first_name": "LISA",
        "middle_name": "H",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MD",
            "license": "R060296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "552105000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

Verify at the official NPI Registry.