Greater Baltimore Medical Center, Inc.
Organization Active NPI Ophthalmology Physician · Baltimore, MD
NPI 1164675906 · NPPES record last updated Aug 7, 2025
Key facts
- NPI
- 1164675906
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ophthalmology Physician 207W00000X
- Legal business name
- GREATER BALTIMORE MEDICAL CENTER, INC.
- Practice address
- 6569 N Charles St Ste 504
Baltimore, MD 21204-5811 - Phone
- (443) 849-2658
- NPI assigned
- Oct 24, 2008
- Organization subpart
- No
Authorized official
- Name
- Joshua Campbell
- Title
- Interim Evp/Cfo
- Phone
- (443) 849-3844
Practitioners 108
-
Michael Alan Ankrom, M.D.
-
Cathleen M Barenski, ACNP
-
Judith Ben-Zev, CRNP
-
Michelle J Bianchi, OTR
-
Jason W Black, M.D.
-
Nicole Bonsavage, MD
-
Julia Brandenburg, CRNP
-
Monique Bruton, FNP
-
Patti Jane Caudill, CCC-SLP
-
Paul Celano, M.D.
-
Gang Chen, M.D., PH.D.
-
James Michael Corkum, M.D.
-
Shauna Marie Costinett, M.D.
-
Laura Marie Cox, CRNP
-
Caren Craig, MD
-
Margaret Cyzeski, MD
-
Stefan David, M.D.
-
Tawanna Marie Deangelis, CRNP
-
Jessica Decostole, MS, RDN, LDN, CDE
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040217000852 | MD | Part B Supplier - Clinic/Group Practice | 1759276975 |
Receives reassigned benefits from 513 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
3346 Paper Mill Rd
Phoenix, MD 21131
Phone (410) 666-4060
6569 N Charles St
Ste 504
Towson, MD 21204
Phone (410) 339-7640
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician |
207W00000X | Yes |
Addresses
Primary practice location
6569 N Charles St Ste 504
Baltimore, MD 21204-5811
Mailing address
6701 N Charles St
S Chapman BLDG, Ste 102
Baltimore, MD 21204
Other names
- Richard E. Hoover Low Vision Rehabilitation Services
Other providers in Baltimore, MD
- Greater Baltimore Medical Center, Inc.
- Greater Baltimore Medical Center, Inc.
- Greater Baltimore Medical Center, Inc.
- Greater Baltimore Medical Center, Inc.
- Greater Baltimore Medical Center, Inc.
- Greater Baltimore Medical Center, Inc.
- Greater Baltimore Medical Center, Inc.
- Greater Baltimore Medical Center, Inc.
- Greater Baltimore Medical Center, Inc.
- Greater Baltimore Medical Center, Inc.
All providers in Baltimore, MD · Ophthalmology Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.