Individual provider Active NPI

Cynthia Carol Mobley, MD

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1184745374
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0040332 Issued in MD
Practice address
1374 W North Ave
Baltimore, MD 21217-3536
Phone
(410) 396-0063
Fax
(410) 669-0071
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 D0040332 MD Primary

Addresses

Primary practice location

1374 W North Ave
Baltimore, MD 21217-3536

Mailing address

3601 Crossland Ave
Baltimore, MD 21213-1006
Phone (410) 889-0884

Other identifiers 1

IdentifierTypeStateIssuer
070241200MedicaidMD

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
I20150303001561 MD Practitioner - Pediatric Medicine 0345566691 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0040332MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Paul Place Specialists Inc CurrentSince Jul 26, 2023 Accepting new patients
St. Paul Place Specialists, Inc. Current Accepting new patients
Emergency Physicians SPPS CurrentSince Feb 1, 2015 Accepting new patients
Saint Paul Place Specialists, Inc. CurrentSince Jul 26, 2023 Accepting new patients

Locations

301 Saint Paul St
Baltimore, MD 21202
Phone (410) 385-4930

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

Interoperability endpoints

  • Direct secure messaging: cmobley47391@direct.mdmercy.com

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1184745374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 CROSSLAND AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212131006",
            "telephone_number": "410-889-0884",
            "fax_number": "410-669-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1374 W NORTH AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212173536",
            "telephone_number": "410-396-0063",
            "fax_number": "410-669-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBLEY",
        "first_name": "CYNTHIA",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0040332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070241200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.