Individual provider Active NPI

Santiago Mazuera Mejia, M.D.

  • Neurology Physician
  • Baltimore, MD
National Provider Identifier
1235484056
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD458423 Issued in PA
Practice address
5951 Greenspring Avenue
Baltimore, MD 21209-4354
Phone
(410) 601-9515
Fax
(410) 601-8905
NPI assigned
Jul 18, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD458423 PA Primary

Addresses

Primary practice location

5951 Greenspring Avenue
Baltimore, MD 21209-4354

Mailing address

5051 Greenspring Ave
Baltimore, MD 21209-4354
Phone (410) 601-9515

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
I20170612002442 MD Practitioner - Neurology 0941598288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Sinai Hospital of Baltimore, IncGroup PAC ID 0941112346, 373 clinicians

Practice addresses (Care Compare)

5051 Greenspring Ave
Baltimore, MD 21209-4354
Phone (410) 601-9513

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD458423PAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Jul 1, 2017 Accepting new patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5051 Greenspring Ave
Ste 200
Baltimore, MD 21209
Phone (410) 367-7600

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

5051 Greenspring Ave
Baltimore, MD 21209
Phone (410) 601-1441

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1235484056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5051 GREENSPRING AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094354",
            "telephone_number": "410-601-9515",
            "fax_number": "410-601-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5951 GREENSPRING AVENUE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094354",
            "telephone_number": "410-601-9515",
            "fax_number": "410-601-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZUERA MEJIA",
        "first_name": "SANTIAGO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD458423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.