Johns Hopkins University

Organization Active NPI Geriatric Medicine (Internal Medicine) Physician · Baltimore, MD

NPI 1104816172 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1104816172
Entity type
Organization (NPI type 2)
Primary specialty
Geriatric Medicine (Internal Medicine) Physician 207RG0300X
Legal business name
JOHNS HOPKINS UNIVERSITY
Practice address
600 N. Wolfe Street
Baltimore, MD 21264-0001
Phone
(410) 558-5238
NPI assigned
Oct 21, 2005
Organization subpart
Yes
Parent organization (as reported)
JOHNS HOPKINS UNIVERSITY

Authorized official

Name
Shavonda L Keating
Title
Sr Production Unit MGR
Phone
(410) 933-6430

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 11

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

Practitioners 2,897

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

View all 2,897

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MD, DC

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Johns Hopkins Home Health Services
Baltimore, MD · CCN 217081B
Home health agency 5% Or Greater Indirect Ownership Interest (50%) Jun 6, 1990
Johns Hopkins Pediatrics at Home
Baltimore, MD · CCN 217131
Home health agency 5% Or Greater Direct Ownership Interest (30%)
5% Or Greater Indirect Ownership Interest (65%)
Dec 7, 1992
Dec 7, 1992

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031215000719 MD Part B Supplier - Clinic/Group Practice 8921903147 Receives reassigned benefits from 4,764 practitioners
This NPI is an additional NPI on the enrollment
O20130530000068 DC Part B Supplier - Clinic/Group Practice 8921903147 Receives reassigned benefits from 2 practitioners
Practice locations: Washington, DC

National Provider Directory

Part of
Johns Hopkins Univ Emer

Locations

5300 Alpha Commons Dr
Baltimore, MD 21224
Phone (410) 550-0477

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RG0300X MD Yes

Addresses

Primary practice location

600 N. Wolfe Street
Baltimore, MD 21264-0001

Mailing address

PO Box 64264
Baltimore, MD 21264-4264

Other identifiers

IdentifierTypeStateIssuer
055237400MedicaidDC
691105600MedicaidMD
CD2563OtherMDRRMC

Other names

  • JHU - MEDICINE/GERIATRICS Doing business as
  • JHU -MEDICINE/GERIATRICS Doing business as

Other providers in Baltimore, MD

All providers in Baltimore, MD · Geriatric Medicine (Internal Medicine) Physician in Maryland

Sources for this page

Verify at the official NPI Registry.