Individual provider Active NPI

Clifford George Andrew, M.D., PH.D.

  • Neurology Physician
  • Severna Park, MD
National Provider Identifier
1164579785
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
D0024290 Issued in MD
Practice address
645 Baltimore Annapolis Blvd
Suite 105
Severna Park, MD 21146-3931
Phone
(410) 647-5000
Fax
(419) 647-5010
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X D0024290 MD Primary

Addresses

Primary practice location

645 Baltimore Annapolis Blvd
Suite 105
Severna Park, MD 21146-3931

Mailing address

132 Saint Andrews Rd
Severna Park, MD 21146-1517
Phone (410) 987-6789

Other identifiers 1

IdentifierTypeStateIssuer
785791800MedicaidMD

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101129000056 MD Practitioner - Neurology 9234325564 Reassigns benefits to 1 organization
Practice locations: Severna Park, MD

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.02 of 100Reported as group
Quality
65.13
Promoting interoperability
98
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0024290MDMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Regional Physicians LLC CurrentSince Jan 1, 2022 Accepting new patients
Johns Hopkins Regional Physicians LLC CurrentSince Jan 1, 2022 Accepting new patients
Johns Hopkins Regional Physicians LLC Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

10710 Charter Dr
Ste 400
Columbia, MD 21044
Phone (410) 997-7979

1300 York Rd
Ste 30D
Lutherville Timonium, MD 21093
Phone (443) 275-1337

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

645 Baltimore Annapolis Blvd
Ste 105
Severna Park, MD 21146
Phone (410) 647-5000

Interoperability endpoints

  • Direct secure messaging: candrew852025@direct.hopkinsmedicine.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1164579785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 SAINT ANDREWS RD",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211461517",
            "telephone_number": "410-987-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 BALTIMORE ANNAPOLIS BLVD",
            "address_2": "SUITE 105",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463931",
            "telephone_number": "410-647-5000",
            "fax_number": "419-647-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREW",
        "first_name": "CLIFFORD",
        "middle_name": "GEORGE",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MD",
            "license": "D0024290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "785791800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

Verify at the official NPI Registry.