Individual provider Active NPI

Evan Mark Braunstein, M.D., PH.D.

  • Hematology & Oncology Physician
  • Baltimore, MD
National Provider Identifier
1194967091
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
D72008 Issued in MD
Practice address
401 North Broadway
Room 1363
Baltimore, MD 21231-1146
Phone
(410) 955-8893
Fax
(410) 955-8587
NPI assigned
Mar 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X D72008 MD Primary

Addresses

Primary practice location

401 North Broadway
Room 1363
Baltimore, MD 21231-1146

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-6421

Other identifiers 1

IdentifierTypeStateIssuer
D72008OtherMDLICENSE

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
I20150716001024 MD Practitioner - HematologyPractitioner - Internal Medicine 7416112099 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D72008MDMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Nov 6, 2016 Accepting new patients
Johns Hopkins University CurrentSince Apr 1, 2020 Accepting new patients
Johns Hopkins University Current Accepting new patients
Johns Hopkins University CurrentSince Apr 1, 2020 Accepting new patients
Johns Hopkins University CurrentSince Nov 6, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

401 N Broadway St
Rm 1363
Baltimore, MD 21287
Phone (410) 955-8893

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

600 N Wolfe St
Baltimore, MD 21287

601 N Caroline St
Baltimore, MD 21287
Phone (410) 955-5080

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

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Organizations & group practices 6

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": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1194967091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-6421",
            "fax_number": "410-955-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NORTH BROADWAY",
            "address_2": "ROOM 1363",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212311146",
            "telephone_number": "410-955-8893",
            "fax_number": "410-955-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUNSTEIN",
        "first_name": "EVAN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-24",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MD",
            "license": "D72008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "D72008",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.