NPIMap

Organization Active NPI

The Heart Center of Northern Anne Arundel County PA

  • Cardiovascular Disease Physician
  • Glen Burnie, MD
National Provider Identifier
1215929369
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
THE HEART CENTER OF NORTHERN ANNE ARUNDEL COUNTY PA
Practice address
1417 Madison Park Dr
Glen Burnie, MD 21061
Phone
(410) 768-6600
Fax
(410) 768-3132
NPI assigned
Aug 16, 2005
Last updated
Aug 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Authorized official

Name
Marc Okun, MDNPI 1295727329
Title
President
Phone
(410) 768-6600

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Clinical Cardiac Electrophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0001X

Addresses

Primary practice location

1417 Madison Park Dr
Glen Burnie, MD 21061

Mailing address

1417 Madison Park Dr
Glen Burnie, MD 21061-5613
Phone (410) 768-6600

Other identifiers 2

IdentifierTypeStateIssuer
406331704MedicaidMD
CF4901OtherMDRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061023000441 MD Part B Supplier - Clinic/Group Practice 0143226910 Receives reassigned benefits from 11 practitioners
Practice locations: Glen Burnie, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534982400000",
    "number": "1215929369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 MADISON PARK DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615613",
            "telephone_number": "410-768-6600",
            "fax_number": "410-768-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 MADISON PARK DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-768-6600",
            "fax_number": "410-768-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HEART CENTER OF NORTHERN ANNE ARUNDEL COUNTY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2018-08-23",
        "status": "A",
        "authorized_official_last_name": "OKUN",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-768-6600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406331704",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CF4901",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.