Individual provider Active NPI

Stephen Wegener, PH.D.

  • Clinical Psychologist
  • Baltimore, MD
National Provider Identifier
1164464632
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
03173 Issued in MD
Practice address
5601 Loch Raven Blvd
Baltimore, MD 21239-2905
Phone
(410) 532-4701
NPI assigned
Jun 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 03173 MD Primary

Addresses

Primary practice location

5601 Loch Raven Blvd
Baltimore, MD 21239-2905

Mailing address

PO Box 64407
Baltimore, MD 21264-4407

Other identifiers 1

IdentifierTypeStateIssuer
338130700MedicaidMD

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100714000087 MD Practitioner - Clinical Psychologist 0840322616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

5601 Lloch Raven Blvd
Baltimore, MD 21239-2945
Phone (443) 444-4714

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03173MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Clinical CurrentSince Feb 28, 1995 Accepting new patients
Johns Hopkins University CurrentSince Feb 28, 1995 Accepting new patients
Johns Hopkins University Current Accepting new patients

Locations

5501 Hopkins Bayview Cir
Baltimore, MD 21224
Phone (410) 550-0545

5601 Loch Raven Blvd
Ste 406
Baltimore, MD 21239
Phone (410) 532-4540

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

Interoperability endpoints

  • Direct secure messaging: swegener36833@direct.hopkinsmedicine.org

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1164464632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64407",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392905",
            "telephone_number": "410-532-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGENER",
        "first_name": "STEPHEN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "03173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "338130700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.