Individual provider Active NPI

Michael Holdsworth, M.D.

  • Emergency Medicine Physician
  • Baltimore, MD
National Provider Identifier
1184990095
Registry record updated May 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D83243 Issued in MD
Practice address
110 S Paca St
6TH Floor, Suite 200
Baltimore, MD 21201-1642
Phone
(410) 328-8025
Fax
(410) 328-8028
NPI assigned
Mar 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D83243 MD Primary

Addresses

Primary practice location

110 S Paca St
6TH Floor, Suite 200
Baltimore, MD 21201-1642

Mailing address

110 S Paca St
6TH Floor, Suite 200
Baltimore, MD 21201-1642
Phone (410) 328-8025

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondingga Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, VA, DC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20170705002041 MD Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 5395014476 Reassigns benefits to 3 organizations
I20240110002518 VA Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 5395014476 Reassigns benefits to 2 organizations
I20240117003231 DC Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 5395014476 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Pediatric Medicine
Education
Emory University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, shared by 17 NPIs, 1,921 clinicians

Practice addresses (Care Compare)

13285 Minnieville Rd
Woodbridge, VA 22192-4018
Phone (703) 986-2400

1701 Twin Springs Rd
Halethorpe, MD 21227-3553
Phone (410) 737-5000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 4, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 4, 2019 Accepting new patients

Locations

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000

10810 Connecticut Ave
Kensington, MD 20895
Phone (301) 929-7100

1221 Mercantile Ln
Fl 3
Largo, MD 20774
Phone (301) 618-5500

655 Watkins Mill Rd
Montgomery Village, MD 20879
Phone (301) 929-7100

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

2101 E Jefferson St
Ste 4EPFS
Rockville, MD 20852

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

2391 Greenspring Dr
Timonium, MD 21093
Phone (410) 847-3000

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

8008 Westpark Dr
Tysons Corner, VA 22102
Phone (703) 287-6400

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

13285 Minnieville Rd
Woodbridge, VA 22192
Phone (703) 986-2400

Organizations & group practices 12

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": "1332633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622246400000",
    "number": "1184990095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S PACA ST",
            "address_2": "6TH FLOOR, SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011642",
            "telephone_number": "410-328-8025",
            "fax_number": "410-328-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S PACA ST",
            "address_2": "6TH FLOOR, SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011642",
            "telephone_number": "410-328-8025",
            "fax_number": "410-328-8028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDSWORTH",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-25",
        "last_updated": "2021-05-29",
        "certification_date": "2021-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D83243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondingga",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1701 Twin Springs Rd",
            "city": "Halethorpe",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212273553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.