NPIMap

Organization Active NPI

Shore Health System, Inc

Doing business as UM Shore Medical Center at Dorchester

  • General Acute Care Hospital
  • Cambridge, MD
National Provider Identifier
1194784751
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
09002 Issued in MD
Legal business name
SHORE HEALTH SYSTEM, INC
Doing business as
UM Shore Medical Center at Dorchester
Practice address
300 Byrn St
Cambridge, MD 21613-1908
Phone
(410) 228-5511
Fax
(410) 221-8123
NPI assigned
Mar 22, 2006
Reactivated
Aug 30, 2011
Last updated
Mar 1, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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

Authorized official

Name
Mr. Kenneth Kozel
Title
President/Ceo
Phone
(410) 822-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 09002 MD Primary

Addresses

Primary practice location

300 Byrn St
Cambridge, MD 21613-1908

Mailing address

300 Byrn St
Cambridge, MD 21613-1908
Phone (410) 228-5511

Other identifiers 1

IdentifierTypeStateIssuer
000305100MedicaidMD

Other names 1

  • UM Shore Medical Center at Dorchester Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040916000602 MD Part A Provider - Hospital 8022906783 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cambridge, MD; Easton, MD; Queenstown, MD

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1194784751. Details of each certification follow.

Hospital certification: CCN 210037

Legal name
SHORE HEALTH SYSTEM INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Nov 22, 2010
Beds
189
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jan 28, 1992 in MD
Enrollment address
219 S Washington St
Easton, MD 21601-2913
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Rehabilitation unit

Hospital certification: CCN 210010

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
DORCHESTER GENL HOSP
Certification status
Terminated Voluntary: merger or closure, Jul 1, 2003
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 4, 1993
Beds
114
Ownership / control type
Private (not for profit)
Facility address
300 Byrn St Box 439
Cambridge, MD 21613

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
University of MD Shore Medical Center at EastonCCN 210037 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 29

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Talli Oxnam Individual Corporate Officer Jul 1, 2024
Corporate Director Jul 1, 2024
Pamela Kasemeyer Individual Corporate Officer Jul 1, 2025
Corporate Director Jul 1, 2025
Thomas B Smyth Individual Corporate OfficerExecutive VP Jan 28, 2026
Corporate Director Jan 28, 2026
Wayne Hockmeyer Individual Corporate Director Jul 1, 2023
Christopher Parry Individual Corporate DirectorBoard Member Jul 1, 2021
Michael Molino Individual Corporate Officer Jul 1, 2025
Corporate Director Jul 1, 2025
Arthur Cecil Individual Corporate DirectorBoard Member Jul 1, 2015 100%
Tom D Seip Individual Corporate DirectorBoard Member Jan 1, 2020
Kim R Herman Individual Corporate DirectorBoard Member Aug 1, 2022
Milton Nagel Individual Corporate Officer Jul 1, 2024
Corporate Director Jul 1, 2024
David Milligan Individual Corporate Officer Jul 1, 2013
Corporate Director Jul 1, 2013
Valerie S Overton Individual Corporate Director Jul 1, 2023
Kenneth Kozel Individual Corporate OfficerPresident & Ceo Oct 1, 2011 100%
W-2 Managing EmployeePresident & Ceo Oct 1, 2011 100%
Keith McMahan Individual Corporate DirectorBoard Member Jul 1, 2008 100%
Garret Falcone Individual Corporate DirectorBoard Member Jul 1, 2021
Charles Capute Individual Corporate DirectorBoard Member Jul 1, 2014 100%
Kevin Morgan Individual Corporate Officer Jul 4, 2025
Corporate Director Jul 4, 2025
Lou S Satchell Individual Corporate DirectorBoard Member Oct 1, 2017
John Ashworth Individual Corporate DirectorBoard Member Jul 1, 2011 100%
Kristin J Bryce Individual Corporate DirectorBoard Member Aug 1, 2022
University of Maryland Medical System Corporation Organization, Baltimore, MD Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2006 100%
Paul S Nicholson Individual Corporate OfficerSr VP, Cfo Nov 11, 2023
Corporate DirectorSr VP, Cfo Nov 11, 2023
Luann Brady Individual Corporate Officer Feb 22, 2023
Corporate Director Feb 22, 2023
Eugene Newmier Individual Corporate Director Aug 1, 2018
Marlene Feldman Individual Corporate Director Jul 1, 2023
Aaron Gabrielian Individual Corporate Officer Jul 1, 2025
Corporate Director Jul 1, 2025
Christopher L Runz Individual Corporate Officer Jul 1, 2024
Corporate Director Jul 1, 2024
Kenny Kreiser Individual Corporate Director Aug 1, 2022
Chrissy Helfenbein Individual Corporate Officer Jul 1, 2024
Corporate Director Jul 1, 2024

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 790

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 790

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519862400000",
    "number": "1194784751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BYRN ST",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131908",
            "telephone_number": "410-228-5511",
            "fax_number": "410-221-8123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BYRN ST",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131908",
            "telephone_number": "410-228-5511",
            "fax_number": "410-221-8123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE HEALTH SYSTEM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2018-03-01",
        "deactivation_date": "2009-01-09",
        "reactivation_date": "2011-08-30",
        "status": "A",
        "authorized_official_last_name": "KOZEL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "410-822-1000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MD",
            "license": "09002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000305100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UM Shore Medical Center at Dorchester",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cambridge, MD

Sources for this page

Verify at the official NPI Registry.