Individual provider Active NPI

Dominick Allan Lanzo, M.D.

  • Orthopaedic Surgery Physician
  • Baltimore, MD
National Provider Identifier
1205826807
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
D0039790 Issued in MD
Practice address
6565 N Charles St
Suite 606
Baltimore, MD 21204-6800
Phone
(443) 849-3838
Fax
(443) 849-3842
NPI assigned
Oct 25, 2005
Last updated
Mar 20, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D0039790 MD
Orthopaedic Surgery Physician 207X00000X D0039790 MD Primary

Addresses

Primary practice location

6565 N Charles St
Suite 606
Baltimore, MD 21204-6800

Mailing address

6565 N Charles St
Suite 606
Baltimore, MD 21204-6800
Phone (443) 849-3838

Other identifiers 1

IdentifierTypeStateIssuer
113611900MedicaidMD

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
I20100517000173 MD Practitioner - Orthopedic Surgery 8022016781 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0039790MDMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Baltimore Medical Center, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Greater Baltimore Medical Center, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Greater Baltimore Medical Center, Inc Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

215 Schilling Cir
Ste 110
Hunt Valley, MD 21031
Phone (410) 657-8008

6565 N Charles St
Ste 606
Towson, MD 21204
Phone (410) 583-0160

6569 N Charles St
Ste 307
Towson, MD 21204
Phone (443) 849-2767

6569 N Charles St
Ste 505
Towson, MD 21204
Phone (443) 849-2196

6569 N Charles St
Ste 705
Towson, MD 21204
Phone (410) 296-0414

Interoperability endpoints

  • Direct secure messaging: dlanzo6666@gbmcdirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1205826807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 N CHARLES ST",
            "address_2": "SUITE 606",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046800",
            "telephone_number": "443-849-3838",
            "fax_number": "443-849-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 N CHARLES ST",
            "address_2": "SUITE 606",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046800",
            "telephone_number": "443-849-3838",
            "fax_number": "443-849-3842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANZO",
        "first_name": "DOMINICK",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0039790",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MD",
            "license": "D0039790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113611900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.