NPIMap

Chesapeake Urology Associates, LLC

Organization Active NPI Urology Physician · Towson, MD

NPI 1124843966 · NPPES record last updated Mar 8, 2025

Key facts

NPI
1124843966
Entity type
Organization (NPI type 2)
Primary specialty
Urology Physician 208800000X
Legal business name
CHESAPEAKE UROLOGY ASSOCIATES, LLC
Practice address
901 Dulaney Valley Rd
Towson, MD 21204-2600
Phone
(410) 757-0422
NPI assigned
Nov 18, 2024
Organization subpart
No

Authorized official

Name
Sanford Jay Siegel, M.D. NPI 1376506477
Title
President
Phone
(410) 581-1600

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Other NPIs on the same Medicare enrollment 22

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

Corporate family (same tax ID) 39

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

View all 39

Practitioners 2

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2272459Chesapeake Urology Associates LLC
901 Dulaney Valley Rd, Towson, MD 21204		Certificate of waiverNov 21, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040510000449 MD Part B Supplier - Clinic/Group Practice 4789673393 Receives reassigned benefits from 195 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Westminster, MD; Towson, MD; Stevensville, MD; Salisbury, MD; Owings Mills, MD; Havre de Grace, MD; Hanover, MD; Glen Burnie, MD…

National Provider Directory

Tax ID family
Chesapeake Urol Assoc LLC (40 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208800000X Yes

Addresses

Primary practice location

901 Dulaney Valley Rd
Towson, MD 21204-2600

Mailing address

10200 Grand Central Ave Ste 220
Owings Mills, MD 21117-4366
Phone (443) 738-2872

Other identifiers

IdentifierTypeStateIssuer
276003701MedicaidMD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 8, 2025.

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741392000000",
    "number": "1124843966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 GRAND CENTRAL AVE STE 220",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174366",
            "telephone_number": "443-738-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DULANEY VALLEY RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042600",
            "telephone_number": "410-757-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE UROLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-08",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "SANFORD",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-581-1600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276003701",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

All providers in Towson, MD · Urology Physician in Maryland

Sources for this page

Verify at the official NPI Registry.