NPIMap

Individual provider Active NPI

Teri Richardson

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1184659088
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0053824 Issued in MD
Practice address
4340 Park Heights Ave
Baltimore, MD 21215-6725
Phone
(410) 542-8130
Fax
(410) 542-1826
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0053824 MD Primary

Addresses

Primary practice location

4340 Park Heights Ave
Baltimore, MD 21215-6725

Mailing address

5010 York Rd
Baltimore, MD 21212-4437
Phone (410) 433-2200

Other identifiers 3

IdentifierTypeStateIssuer
174180002OtherMDJAI MEDICAL SYSTEM MCO
529210701MedicaidMD
54783603OtherMDBLUECROSS/BLUESHEILD MD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101230000597 MD Practitioner - Internal Medicine 3072701325 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Howard University College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Heights Medical Clinic LLCGroup PAC ID 7012012651, 7 clinicians

Practice addresses (Care Compare)

4340 Park Heights Ave
Baltimore, MD 21215-6725
Phone (410) 542-8130

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
25.61 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
85.38

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Park Heights Medical Clinic LLC CurrentSince Oct 5, 1998 Accepting new patients
Hollis Seunarine Mdpa LLC CurrentSince Jan 19, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5010 York Rd
Baltimore, MD 21212
Phone (410) 433-2200

4340 Park Heights Ave
Baltimore, MD 21215
Phone (410) 542-8130

301 International Cir
Hunt Valley, MD 21030
Phone (410) 433-2200

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184659088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 YORK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212124437",
            "telephone_number": "410-433-2200",
            "fax_number": "410-532-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 PARK HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212156725",
            "telephone_number": "410-542-8130",
            "fax_number": "410-542-1826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "TERI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0053824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JAI MEDICAL SYSTEM MCO",
            "identifier": "174180002",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529210701",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHEILD MD",
            "identifier": "54783603",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.