NPIMap

Organization Active NPI

Grace Medical Center, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
National Provider Identifier
1104151091
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
GRACE MEDICAL CENTER, INC.
Practice address
2000 W Baltimore St
Baltimore, MD 21223-1558
Phone
(410) 362-3000
Fax
(301) 631-1002
NPI assigned
Oct 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Authorized official

Name
Rebecca A Altman
Title
VP
Phone
(443) 924-1856

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

2000 W Baltimore St
Baltimore, MD 21223-1558

Mailing address

2000 W Baltimore St
Baltimore, MD 21223-1558
Phone (410) 362-3000

Other identifiers 1

IdentifierTypeStateIssuer
419888300MedicaidMD

Other names 1

  • Department of Behavioral Health Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100215000024 MD Part B Supplier - Hospital Department(S) 0446216832 Receives reassigned benefits from 17 practitioners
2 other NPIs on this enrollment
Practice locations: Baltimore, MD

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Bon Secours Hospital-Em12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

3101 Towanda Ave
Baltimore, MD 21215
Phone (410) 362-3533

2901 Druid Park Dr
Ste A103
Baltimore, MD 21215

Practitioners & affiliated clinicians

Practitioners 67

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1104151091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W BALTIMORE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212231558",
            "telephone_number": "410-362-3000",
            "fax_number": "301-631-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BALTIMORE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212231558",
            "telephone_number": "410-362-3000",
            "fax_number": "301-631-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-09",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "ALTMAN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "443-924-1856"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419888300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Department of Behavioral Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.