NPIMap

Individual provider Active NPI

Enrique Ivan Oviedo, MD

  • Psychiatry Physician
  • Dundalk, MD
National Provider Identifier
1255534756
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0068379 Issued in MD
Practice address
40 S Dundalk Ave Ste 400
Dundalk, MD 21222-4273
Phone
(410) 220-0780
Fax
(410) 862-0150
NPI assigned
Jun 11, 2007
Last updated
Aug 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D0068379 MD Primary

Addresses

Primary practice location

40 S Dundalk Ave Ste 400
Dundalk, MD 21222-4273

Mailing address

6705 Evanston Rd
Baltimore, MD 21209-3865
Phone (410) 220-0780

Other identifiers 2

IdentifierTypeStateIssuer
D0068379OtherMDSTATE LICENSE
445126100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120509000422 MD Practitioner - Psychiatry 2769644764 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York at Buffalo School of Medicine, 2007
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

40 S Dundalk Ave
Suite 400
Dundalk, MD 21222-4273
Phone (410) 220-0720

6999 Reisterstown Rd
Baltimore, MD 21215-1430
Phone (667) 600-3210

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Catholic Charities, Inc. Current Accepting new patients
Matclinic Physicians Practice Group LLC Psychiatry CurrentSince Oct 1, 2019 Accepting new patients
Associated Catholic Charities, Inc. CurrentSince Dec 1, 2017 Accepting new patients
University of Maryland Psychiatry Associates, PA Psychiatry CurrentSince Jul 1, 2012 Accepting new patients
Matclinic Physicians Practice Group LLC CurrentSince Jul 8, 2019 Accepting new patients
Associated Catholic Charities, Inc CurrentSince Dec 1, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

6999 Reisterstown Rd
Baltimore, MD 21215
Phone (667) 600-2000

701 W Pratt St
Baltimore, MD 21201
Phone (410) 328-5881

701 W Pratt St
Fl 4
Baltimore, MD 21201
Phone (410) 328-3522

308 Virginia Ave
Cumberland, MD 21502
Phone (667) 600-2110

40 S Dundalk Ave
Ste 400
Dundalk, MD 21222
Phone (410) 220-0270

300 W 9th St
Frederick, MD 21701
Phone (301) 662-8119

2700 Washington Ave
Lansdowne, MD 21227
Phone (667) 600-3984

2300 Dulaney Valley Rd
Ste B
Timonium, MD 21093

40 York Rd
Ste 201
Towson, MD 21204
Phone (410) 220-0780

Interoperability endpoints

  • Direct secure messaging: eoviedo7644@direct.umm.edu

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1255534756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6705 EVANSTON RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093865",
            "telephone_number": "410-220-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 S DUNDALK AVE STE 400",
            "city": "DUNDALK",
            "state": "MD",
            "postal_code": "212224273",
            "telephone_number": "410-220-0780",
            "fax_number": "410-862-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVIEDO",
        "first_name": "ENRIQUE",
        "middle_name": "IVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0068379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "D0068379",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "445126100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dundalk, MD

Sources for this page

Verify at the official NPI Registry.