Active NPI
Stephanie Detterline, MD
- Internal Medicine Physician
- Baltimore, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- D67439
- Practice address
- 201 E University Pkwy
33Rd St. Professional BLDG, Ste 405
Baltimore, MD 21218-2829 - Phone
- (410) 554-2284
- Fax
- (410) 554-2184
- NPI assigned
- Feb 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 36113740 | IL | |
| Hospitalist Physician | 208M00000X | 036113740 | IL | |
| Internal Medicine Physician | 207R00000X | 35089436 | OH | |
| Hospitalist Physician | 208M00000X | 35089436 | OH | |
| Internal Medicine Physician | 207R00000X | D67439 | MD | Primary |
Addresses
Primary practice location
201 E University Pkwy
33Rd St. Professional BLDG, Ste 405
Baltimore, MD 21218-2829
Mailing address
201 E University Pkwy
33Rd St. Professional BLDG, Ste 405
Baltimore, MD 21218-2829
Phone (410) 554-2284
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100007510 | Medicaid | KY | |
| 2745748 | Medicaid | OH | |
| 36113740 | Medicaid | IL | |
| 200867020 | Medicaid | IN |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Indiana University School of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
201 E University Pkwy
Baltimore, MD 21218-2829
Phone (410) 554-2000
Hospital & facility affiliations
- Medstar Franklin Square Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.34 of 100
- Quality
- 67.9
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 69.47
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36113740 | IL | MD | Internal Medicine Physician |
| D67439 | MD | MD | Internal Medicine Physician |
| 036113740 | IL | MD | Hospitalist Physician |
| 35089436 | OH | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Medical Group II LLC | Current | Accepting new patients | |
| Union Memorial Hospital | Past | Accepting new patients | |
| University Internal Medicine Associates, Inc. | Internal Medicine | Past | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714
201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651
1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440
9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000
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 and National Provider Directory roles.
-
- General Practice Physician
- Baltimore, MD
- NPI 1184046187
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Multi-Specialty Clinic/Center
- Baltimore, MD
- NPI 1336163781
-
- Internal Medicine Physician
- Cincinnati, OH
- NPI 1588620850
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Baltimore, MD
- NPI 1184712085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321833600000",
"number": "1104890367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 E UNIVERSITY PKWY",
"address_2": "33RD ST. PROFESSIONAL BLDG, STE 405",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212182829",
"telephone_number": "410-554-2284",
"fax_number": "410-554-2184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 E UNIVERSITY PKWY",
"address_2": "33RD ST. PROFESSIONAL BLDG, STE 405",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212182829",
"telephone_number": "410-554-2284",
"fax_number": "410-554-2184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETTERLINE",
"first_name": "STEPHANIE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-15",
"last_updated": "2011-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "36113740",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IL",
"license": "036113740",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35089436",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "OH",
"license": "35089436",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D67439",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100007510",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2745748",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36113740",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200867020",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
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 Nov 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.