Individual provider Active NPI

Grigorios A Lamaris, MD, PHD

  • Plastic Surgery Physician
  • Baltimore, MD
National Provider Identifier
1265691166
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
D0095330 Issued in MD
Practice address
110 S Paca St
Baltimore, MD 21201-1642
Phone
(103) 283-0584
Fax
(410) 328-8862
NPI assigned
Jun 5, 2008
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X D0095330 MD Primary

Addresses

Primary practice location

110 S Paca St
Baltimore, MD 21201-1642

Mailing address

150 Harvester Dr
Suite 300
Burr Ridge, IL 60527-5919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210924002725 IL Practitioner - Plastic and Reconstructive Surgery 6507119955 Reassigns benefits to 1 organization
I20221021000070 MD Practitioner - Plastic and Reconstructive Surgery 6507119955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shock Trauma Associates PAGroup PAC ID 6800882317, 258 clinicians

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-6704

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0095330MDMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Aug 19, 2021 Accepting new patients
The University of Chicago Medical Center CurrentSince Aug 19, 2021 Accepting new patients
Shock Trauma Associates, P.a. CurrentSince Sep 6, 2022 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

Interoperability endpoints

  • Direct secure messaging: glamaris928493@direct.umm.edu

Organizations & group practices 3

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.

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": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1265691166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR",
            "address_2": "SUITE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S PACA ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011642",
            "telephone_number": "103-283-0584",
            "fax_number": "410-328-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMARIS",
        "first_name": "GRIGORIOS",
        "middle_name": "A",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-05",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MD",
            "license": "D0095330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.