NPIMap

Organization Active NPI

Greater Maryland Pain Management, LLC

Doing business as Greater Maryland Pain Management

  • Pain Medicine (Anesthesiology) Physician
  • Elkridge, MD
National Provider Identifier
1205664935
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
GREATER MARYLAND PAIN MANAGEMENT, LLC
Doing business as
Greater Maryland Pain Management
Practice address
8186 Lark Brown Rd Ste 302
Elkridge, MD 21075-6435
Phone
(410) 672-2555
Fax
(410) 816-9472
NPI assigned
Jul 24, 2024
Last updated
Jul 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Janak Vidyarthi, MDNPI 1619170685
Title
Ceo
Phone
(410) 672-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU Primary

Addresses

Primary practice location

8186 Lark Brown Rd Ste 302
Elkridge, MD 21075-6435

Mailing address

1130 Annapolis Rd Ste 100
Odenton, MD 21113-1622
Phone (410) 672-2255

Other names 1

  • Greater Maryland Pain Management Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250417000864 MD DME Supplier - Physician - Interventional Pain Management 4486881513 Practice locations: Elkridge, MD

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Greater Maryland Pain Management LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1205664935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 ANNAPOLIS RD STE 100",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211131622",
            "telephone_number": "410-672-2255",
            "fax_number": "410-816-9472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8186 LARK BROWN RD STE 302",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756435",
            "telephone_number": "410-672-2555",
            "fax_number": "410-816-9472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER MARYLAND PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "VIDYARTHI",
        "authorized_official_first_name": "JANAK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-672-2225",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Maryland Pain Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.