NPIMap

Organization Active NPI

Mt Washington Pediatric Hospital Inc

  • Special Hospital
  • Baltimore, MD
National Provider Identifier
1093871329
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Special HospitalTaxonomy code 284300000X
License
30-026 Issued in MD
Legal business name
MT WASHINGTON PEDIATRIC HOSPITAL INC
Practice address
1708 W Rogers Ave
Baltimore, MD 21209
Phone
(410) 578-8600
Fax
(410) 578-0566
NPI assigned
Dec 29, 2006
Last updated
Jun 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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

Authorized official

Name
Mary Miller
Title
Director of Finance
Phone
(410) 578-5163

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Special Hospital 284300000X 30-026 MD Primary

Addresses

Primary practice location

1708 W Rogers Ave
Baltimore, MD 21209

Mailing address

1708 W Rogers Ave
Baltimore, MD 21209
Phone (410) 578-8600

Other identifiers 1

IdentifierTypeStateIssuer
951175000MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110627000156 MD Part A Provider - Hospital 6901891241 Practice locations: Baltimore, MD; Largo, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093871329. Details of each certification follow.

Hospital certification: CCN 213300

Legal name
MT WASHINGTON PEDIATRIC HOSPITAL INC
Doing business as
MT WASHINGTON PHYSICIANS GROUP
Certification status
Active
Provider type (POS)
Hospital – Children’s
Participating since
Jul 1, 1984
Last certification
Nov 9, 2016
Beds
117
Ownership / control type
Private (not for profit)
Organization structure
CorporationProprietary
Incorporated
May 8, 1922 in MD
Enrollment address
1708 W Rogers Ave
Baltimore, MD 21209-4545
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation unit, Other

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mount Washington Pediatric HospitalCCN 213300 · All quality measures
Type
Childrens
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Mt Washington Pediatric Hospital8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1500 Dixon St
Ste 201
Fredericksburg, VA 22401
Phone (540) 374-5261

Ownership & related parties

All disclosed owners & managing parties 27

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Katherine Pabich Individual Corporate OfficerAsst Secretary to Board of Trustees Jan 26, 2022
Jacqueline Newton Individual Corporate OfficerChief Nursing Officer Jan 6, 2025
Kevin K Sowers Individual Corporate Director Jul 1, 2018
Susan Tracy Coster Individual Corporate Director Jul 1, 2006
Mary Miller Individual Corporate OfficerChief Financial Officer Jul 20, 1998
W-2 Managing EmployeeChief Financial Officer Jul 20, 1998
Justina Starobin Individual Corporate OfficerVP Outpatient Services Jul 18, 2011
William Christopher Golden Individual Corporate Director Jul 1, 2022
Jill Feinberg Individual Corporate Officer Dec 1, 2016
Scott Klein Individual Corporate OfficerCeo Jul 1, 2023
W-2 Managing EmployeeCeo Jul 1, 2023
Monica Atkinson Individual Corporate OfficerVP HR & Org Development Oct 6, 2025
Dana Farrakhan Individual Corporate Director Jul 1, 2024
Karen E Doyle Individual Corporate Director Sep 23, 2019
Brenda Banwell Individual Corporate Director Sep 1, 2024
Beth Lauren Armacost Individual Corporate Director Jul 1, 2022
The Johns Hopkins Health System Corporation Organization, Baltimore, MD 5% Or Greater Direct Ownership Interest Jul 1, 2006
Beryl Rosenstein Individual Corporate Director Jul 1, 2010
Steven J Czinn Individual Corporate Director Jul 1, 2006
University of Maryland Medical System Corporation Organization, Baltimore, MD 5% Or Greater Direct Ownership Interest Jul 1, 2006
Lisa Arce-Williams Individual Corporate OfficerSecretary of Board of Trustees Jan 26, 2022
Mohan Suntha Individual Corporate Director Sep 23, 2019
David Hackam Individual Corporate Director Sep 29, 2017
Mark Wietecha Individual Corporate OfficerBoard Member Jul 1, 2025
Krishnaj Gourab Individual Corporate Director Jul 1, 2023
Jason W Custer Individual Corporate OfficerChief Medical Officer & Vpma Jan 2, 2026
Margaret R Moon Individual Corporate Director Jul 1, 2020
Aaron Joseph Rabinowitz Individual Corporate Director Jul 1, 2024
Peter B Mancino Individual Corporate Director Sep 23, 2021

Owners & managing parties with NPI records 9

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 20

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 20

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

Affiliated clinicians 1

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": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309132800000",
    "number": "1093871329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 W ROGERS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21209",
            "telephone_number": "410-578-8600",
            "fax_number": "410-578-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 W ROGERS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21209",
            "telephone_number": "410-578-8600",
            "fax_number": "410-578-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT WASHINGTON PEDIATRIC HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2011-06-27",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "410-578-5163"
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "MD",
            "license": "30-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "951175000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.