Individual provider Active NPI

Mark Frederic Williams, M.D.

  • Otolaryngology Physician
  • Lutherville, MD
National Provider Identifier
1104820828
Registry record updated Apr 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
D0043030 Issued in MD
Practice address
1205 York Rd
Ste 33
Lutherville, MD 21093-6211
Phone
(410) 494-7060
Fax
(410) 832-5202
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X D0043030 MD Primary

Addresses

Primary practice location

1205 York Rd
Ste 33
Lutherville, MD 21093-6211

Mailing address

1205 York Rd
Ste 33
Lutherville, MD 21093-6211
Phone (410) 494-7060

Other identifiers 1

IdentifierTypeStateIssuer
076331400MedicaidMD

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
I20110128000187 MD Practitioner - Otolaryngology 1355520933 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Medical College of Georgia School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Greater Baltimore Medical CenterGroup PAC ID 1759276975, 350 clinicians

Practice addresses (Care Compare)

1205 York Rd
Lutherville, MD 21093-6211
Phone (410) 494-7060

6535 N Charles St
Baltimore, MD 21204-5829

Hospital & facility affiliations

  • Sentara RMH Medical Center Hospital, Harrisonburg, VA, CCN 490004

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Baltimore Medical Center, Inc. CurrentSince Mar 27, 2011 Accepting new patients
DRS. Price & Williams LLC Otolaryngology CurrentSince Apr 1, 2002 Accepting new patients
Greater Baltimore Medical Center, Inc Current Accepting new patients
Greater Baltimore Medical Center, Inc. CurrentSince Mar 27, 2011 Accepting new patients
DRS. Price & Williams, LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1205 York Rd
Ste 33
Lutherville Timonium, MD 21093
Phone (410) 494-7060

6569 N Charles St
Ste 505
Towson, MD 21204
Phone (443) 849-2196

6535 N Charles St
Ste 250
Towson, MD 21204
Phone (443) 849-2140

6569 N Charles St
Ste 307
Towson, MD 21204
Phone (443) 849-2767

Interoperability endpoints

  • Direct secure messaging: mwilliams15946@gbmcdirect.org

Organizations & group practices 6

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1104820828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 YORK RD",
            "address_2": "STE 33",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936211",
            "telephone_number": "410-494-7060",
            "fax_number": "410-832-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 YORK RD",
            "address_2": "STE 33",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936211",
            "telephone_number": "410-494-7060",
            "fax_number": "410-832-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARK",
        "middle_name": "FREDERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D0043030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076331400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

Verify at the official NPI Registry.