Bayside Recovery LLC | NPI 1235516469

Key facts

NPI: 1235516469
Entity type: Organization (NPI type 2)
Primary specialty: Community/Behavioral Health Agency 251S00000X
Legal business name: BAYSIDE RECOVERY LLC
Practice address: 440 Solomons Island Rd N
Suite 222
Prince Frederick, MD 20678-3941
Phone: (443) 486-5680
Fax: (443) 486-5679
NPI assigned: Apr 27, 2015
Organization subpart: No

Authorized official

Name: Mr. Robert Galaher
Title: Program Sponsor
Phone: (410) 991-5687

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Baekcheol Lee, NP Family Nurse Practitioner · Germantown, MD · NPI 1114405537

NPD
John Francis Dombrowski Addiction Medicine (Anesthesiology) Physician · Washington, DC · NPI 1154329126

NPD
Michael James Bauer Blood Banking & Transfusion Medicine Physician · Castle Rock, CO · NPI 1346417086

NPD (past)
Kevin Paul Rosenblatt, MD PHD Clinical Pathology/Laboratory Medicine Physician · Bellaire, TX · NPI 1689633711

NPD (past)

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
21D2118394	Bayside Recovery LLC 440 Solomons Island Rd N #222, Prince Frederick, MD 20678	Certificate of waiver	Sep 6, 2026

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MD
Opioid treatment program: Medicare-enrolled since Jun 18, 2020

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20201023001673	MD	Part B Supplier - Opioid Treatment Program (Otp)	8224469978	Practice locations: Prince Frederick, MD

National Provider Directory

Locations

440 Solomons Island Rd N
Ste 222
Prnc Frederck, MD 20678
Phone (410) 862-8860

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Community/Behavioral Health Agency	251S00000X			Yes

Addresses

Primary practice location

440 Solomons Island Rd N
Suite 222
Prince Frederick, MD 20678-3941

Mailing address

440 Solomons Island Rd N
Suite 222
Prince Frederick, MD 20678-3941
Phone (443) 486-5680

Other providers in Prince Frederick, MD

Sylvia Bongers Batong, M.D.
Amanda Batson
Alexa Bauer, CRNP
Bayside Physical Therapy & Sports Rehabilitation Limited Partnership
Bayside Primary Care LLC
Kimberly Joan Beall, BA, CAC-AD
Deborah Helene Bear, MD
Micah Beaston
Mary Margaret Beattie, DDS
Bruce Lee Beck, M.D.

All providers in Prince Frederick, MD · Community/Behavioral Health Agency in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.