Active NPI
Grace Gia-Ling Wong Casserly, MD
- Internal Medicine Physician
- Halethorpe, MD
National Provider Identifier
1154735587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- D0083021
- Practice address
- 1701 Twin Springs Rd
Halethorpe, MD 21227 - Phone
- (410) 737-5000
- NPI assigned
- Jun 13, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | D0083021 | MD | Primary |
| Internal Medicine Physician | 207R00000X | A169212 | CA |
Addresses
Primary practice location
1701 Twin Springs Rd
Halethorpe, MD 21227
Mailing address
2 Upper Ragsdale Dr BLDG a
Monterey, CA 93940-5736
Phone (831) 333-3040
Other practice location 1
2401 W Belvedere Ave
Baltimore, MD 21215-5216
Phone (410) 601-9386
Other practice location 2
2 Upper Ragsdale Dr Bldg A
Monterey, CA 93940-5736
Phone (831) 333-3040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200827000209 | CA | Practitioner - Internal Medicine | 1951527019 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Southern California Keck School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Montage Medical Group
Practice addresses (Care Compare)
2 Upper Ragsdale Dr
BLDG a
Monterey, CA 93940-5736
Phone (831) 718-9701
Hospital & facility affiliations
- Central Coast Vna & Hospice, Inc
- Community Hospital of the Monterey Peninsula
- Stanford Health Care
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A169212 | CA | MD | Internal Medicine Physician |
| D0083021 | MD | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montage Medical Group | Internal Medicine | Current | Accepting new patients |
Locations
23845 Holman Hwy
Ste 210
Monterey, CA 93940
Phone (831) 620-0296
100 Wilson Rd
Ste 100
Monterey, CA 93940
Phone (831) 242-8301
2 Upper Ragsdale Dr
Bldg A
Monterey, CA 93940
Phone (831) 333-3040
Organizations & group practices 1
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 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Monterey, CA
- NPI 1093718884
-
- Psychiatric Hospital Unit
- Monterey, CA
- NPI 1679562169
Hospital
-
- General Acute Care Hospital
- Monterey, CA
- NPI 1932197258
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597968000000",
"number": "1154735587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 UPPER RAGSDALE DR BLDG A",
"city": "MONTEREY",
"state": "CA",
"postal_code": "939405736",
"telephone_number": "831-333-3040",
"fax_number": "831-886-3639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 TWIN SPRINGS RD",
"city": "HALETHORPE",
"state": "MD",
"postal_code": "21227",
"telephone_number": "410-737-5000"
}
],
"practiceLocations": [
{
"address_1": "2401 W Belvedere Ave",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212155216",
"country_code": "US",
"telephone_number": "410-601-9386",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2 Upper Ragsdale Dr Bldg A",
"address_purpose": "LOCATION",
"city": "Monterey",
"state": "CA",
"postal_code": "939405736",
"country_code": "US",
"telephone_number": "831-333-3040",
"fax_number": "831-886-3639",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CASSERLY",
"first_name": "GRACE",
"middle_name": "GIA-LING WONG",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-13",
"last_updated": "2020-08-21",
"certification_date": "2020-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D0083021",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A169212",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Halethorpe, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; 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.