Individual provider Active NPI

Vivian Y Pao, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Timonium, MD
National Provider Identifier
1265604870
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
D68920 Issued in MD
Practice address
1 Texas Station CT
Suite 300
Timonium, MD 21093-8286
Phone
(410) 828-7417
Fax
(410) 828-4695
NPI assigned
Mar 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A85813 CA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X D68920 MD Primary

Addresses

Primary practice location

1 Texas Station CT
Suite 300
Timonium, MD 21093-8286

Mailing address

1 Texas Station CT
Suite 300
Timonium, MD 21093-8286
Phone (410) 828-7417

Other identifiers 1

IdentifierTypeStateIssuer
422155900MedicaidMD

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
I20100512000501 MD Practitioner - Endocrinology 7719902188 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Washington University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

133 Defense Hwy
Annapolis, MD 21401-7015

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A85813CAMDEndocrinology, Diabetes & Metabolism Physician
D68920MDMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Oct 6, 2017 Accepting new patients
Bay East Endocrinology Associates PA Endocrinology, Diabetes & Metabolism Current Accepting new patients
Bay West Endocrinology Associates CurrentSince Jan 19, 2010 Accepting new patients
Privia Medical Group, LLC Endocrinology, Diabetes & Metabolism Current Accepting new patients
Privia Medical Group, LLC CurrentSince Oct 6, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

1 Texas Station Ct
Ste 300
Timonium, MD 21093
Phone (410) 683-2110

6535 N Charles St
Ste 400
Towson, MD 21204
Phone (410) 828-7417

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: vivian.pao.1@8042.direct.athenahealth.com

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.

Hospital & facility affiliations 2

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": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1265604870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TEXAS STATION CT",
            "address_2": "SUITE 300",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210938286",
            "telephone_number": "410-828-7417",
            "fax_number": "410-828-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TEXAS STATION CT",
            "address_2": "SUITE 300",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210938286",
            "telephone_number": "410-828-7417",
            "fax_number": "410-828-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAO",
        "first_name": "VIVIAN",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-24",
        "last_updated": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A85813",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MD",
            "license": "D68920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "422155900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Timonium, MD

Sources for this page

Verify at the official NPI Registry.