Individual provider Active NPI

Sol Dominic Bugayong Sebastian, ACNP-BC

  • Acute Care Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1124585021
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R176780 Issued in MD
Practice address
2401 W Belvedere Ave
Baltimore, MD 21215-5216
Phone
(443) 564-2368
NPI assigned
Feb 27, 2019
Last updated
Jan 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R176780 MD Primary

Addresses

Primary practice location

2401 W Belvedere Ave
Baltimore, MD 21215-5216

Mailing address

2401 W Belvedere Ave
Baltimore, MD 21215-5270
Phone (443) 564-2368

Other practice location 1

900 Elkridge Landing Rd Fl 2
Linthicum, MD 21090-2924
Phone (410) 337-1000

Other practice location 2

7601 Osler Dr
Towson, MD 21204-7700
Phone (410) 337-1000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190502001646 MD Practitioner - Nurse Practitioner 6002158581 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Sinai Hospital of Baltimore, IncGroup PAC ID 0941112346, 373 clinicians

Practice addresses (Care Compare)

2401 W Belvedere Ave
Sinai Cardiovascular Faculty
Baltimore, MD 21215-5271
Phone (410) 601-8702

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.09 of 100Reported as group
Quality
79.06
Promoting interoperability
100
Improvement activities
40
Cost
77.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R176780MDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Jan 22, 2024 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Sep 18, 2019 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Sep 18, 2019 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Jan 22, 2024 Accepting new patients
Sinai Hospital of Baltimore Inc Past Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1124585021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155270",
            "telephone_number": "443-564-2368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "443-564-2368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Elkridge Landing Rd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Linthicum",
            "state": "MD",
            "postal_code": "210902924",
            "country_code": "US",
            "telephone_number": "410-337-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7601 Osler Dr",
            "address_purpose": "LOCATION",
            "city": "Towson",
            "state": "MD",
            "postal_code": "212047700",
            "country_code": "US",
            "telephone_number": "410-337-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEBASTIAN",
        "first_name": "SOL DOMINIC",
        "middle_name": "BUGAYONG",
        "name_prefix": "Mr.",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-27",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R176780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.