Individual provider Active NPI

Stacey L Seidel, MD

  • Pediatrics Physician
  • Columbia, MD
National Provider Identifier
1184647331
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D64555 Issued in MD
Practice address
5755 Cedar LN
Columbia, MD 21044-2912
Phone
(410) 884-4888
Fax
(410) 884-4887
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D64555 MD Primary

Addresses

Primary practice location

5755 Cedar LN
Columbia, MD 21044-2912

Mailing address

500 Upper Chesapeake Dr
Dept. of Emergency Medicine
Bel Air, MD 21014-4324
Phone (443) 643-2110

Other practice location 1

500 Upper Chesapeake Dr
Dept. of Emergency Medicine
Bel Air, MD 21014-4324
Phone (443) 643-2110

Other identifiers 2

IdentifierTypeStateIssuer
413046400MedicaidMD
410595800MedicaidMD

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
I20070207000630 MD Practitioner - Pediatric Medicine 5092717801 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Chesapeake Medical Services, Inc CurrentSince Jun 1, 2020 Accepting new patients
Johns Hopkins University CurrentSince Oct 1, 2022 Accepting new patients
Johns Hopkins University CurrentSince Oct 1, 2022 Accepting new patients
Howard County General Hospital, Inc, Past Accepting new patients

Locations

500 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (443) 643-1000

520 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (410) 836-0128

5755 Cedar Ln
Columbia, MD 21044
Phone (410) 381-7171

501 S Union Ave
Hvre de Grace, MD 21078
Phone (301) 939-2400

Interoperability endpoints

  • Direct secure messaging: sseidel875969@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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1184647331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UPPER CHESAPEAKE DR",
            "address_2": "DEPT. OF EMERGENCY MEDICINE",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144324",
            "telephone_number": "443-643-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 CEDAR LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442912",
            "telephone_number": "410-884-4888",
            "fax_number": "410-884-4887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Upper Chesapeake Dr",
            "address_2": "Dept. of Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "Bel Air",
            "state": "MD",
            "postal_code": "210144324",
            "country_code": "US",
            "telephone_number": "443-643-2110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEIDEL",
        "first_name": "STACEY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D64555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "413046400",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410595800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.