Individual provider Active NPI

Michael Crocetti, M.D.

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1255371399
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D50569 Issued in MD
Practice address
JHCP Canton Crossing - 1501 S. Clinton St
Suite #200
Baltimore, MD 21224
Phone
(410) 522-9940
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D50569 MD Primary

Addresses

Primary practice location

JHCP Canton Crossing - 1501 S. Clinton St
Suite #200
Baltimore, MD 21224

Mailing address

9910 Franklin Square Dr Ste 2110
Baltimore, MD 21236-4902
Phone (410) 933-5412

Other identifiers 1

IdentifierTypeStateIssuer
139805900MedicaidMD

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
I20100309000515 MD Practitioner - Pediatric Medicine 0345385753 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Eastern Virginia Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 E Eager St
E Baltimore Med Ctr
Baltimore, MD 21202-5533
Phone (410) 522-9800

1501 S Clinton St
Suite 200
Baltimore, MD 21224-5748
Phone (410) 522-9940

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Jan 19, 2010 Accepting new patients
Johns Hopkins University CurrentSince Jan 19, 2010 Accepting new patients
Johns Hopkins Community Physicians CurrentSince Aug 14, 2010 Accepting new patients
Johns Hopkins University Current Accepting new patients
Johns Hopkins Community Physicians, Inc Pediatrics CurrentSince Aug 14, 2010 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

200 N Wolfe St
Baltimore, MD 21287
Phone (410) 614-3917

1501 S Clinton St
Baltimore, MD 21224
Phone (443) 562-2536

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

601 N Caroline St
Baltimore, MD 21287
Phone (410) 955-5080

1501 S Clinton St
Ste 200
Baltimore, MD 21224
Phone (410) 522-9940

600 N Wolfe St
Baltimore, MD 21287

9910 Franklin Square Dr
#2110
Nottingham, MD 21236
Phone (410) 933-5412

Interoperability endpoints

  • Direct secure messaging: mcrocetti6908@direct.hopkinsmedicine.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1255371399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 FRANKLIN SQUARE DR STE 2110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364902",
            "telephone_number": "410-933-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JHCP CANTON CROSSING - 1501 S. CLINTON ST",
            "address_2": "SUITE #200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21224",
            "telephone_number": "410-522-9940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCETTI",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D50569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139805900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.