Active NPI
Orn Eliasson, M.D., M.P.H.
- Pulmonary Disease Physician
- Baltimore, MD
National Provider Identifier
1205859667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- D0031076
- Practice address
- 9106 Philadelphia Rd Ste 200
Baltimore, MD 21237-4333 - Phone
- (410) 995-9052
- Fax
- (410) 995-9050
- NPI assigned
- Jul 26, 2006
- Last updated
- Jul 20, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | D0031076 | MD | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | D0031076 | MD | |
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | D0031076 | MD | |
| Pulmonary Disease Physician | 207RP1001X | D0031076 | MD | Primary |
Addresses
Primary practice location
9106 Philadelphia Rd Ste 200
Baltimore, MD 21237-4333
Mailing address
11711 Foxspur CT
Ellicott City, MD 21042-1515
Phone (410) 960-4899
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 406471200 | Medicaid | MD |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120904000018 | MD | Practitioner - Pulmonary Disease | 1658309430 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0031076 | MD | MD | Preventive Medicine/Occupational Environmental Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689811200000",
"number": "1205859667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11711 FOXSPUR CT",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210421515",
"telephone_number": "410-960-4899",
"fax_number": "410-995-9052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9106 PHILADELPHIA RD STE 200",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212374333",
"telephone_number": "410-995-9052",
"fax_number": "410-995-9050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELIASSON",
"first_name": "ORN",
"name_prefix": "Dr.",
"credential": "M.D., M.P.H.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2023-07-20",
"certification_date": "2023-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D0031076",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "MD",
"license": "D0031076",
"primary": false
},
{
"code": "2083P0500X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
"state": "MD",
"license": "D0031076",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "MD",
"license": "D0031076",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "406471200",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.