NPIMap

Organization Active NPI

Johns Hopkins University

Doing business as Jhu - Plastic Surgery

  • Plastic Surgery Physician
  • Baltimore, MD
National Provider Identifier
1275515546
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
JOHNS HOPKINS UNIVERSITY
Doing business as
Jhu - Plastic Surgery
Practice address
4940 Eastern Ave
Baltimore, MD 21224-2735
Phone
(410) 550-8400
NPI assigned
Nov 14, 2005
Last updated
Apr 7, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
JOHNS HOPKINS UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Authorized official

Name
Shavonda L Keating
Title
Sr Production Unit MGR
Phone
(410) 933-6430

Specialties & licenses 1

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

Addresses

Primary practice location

4940 Eastern Ave
Baltimore, MD 21224-2735

Mailing address

PO Box 64165
Baltimore, MD 21264-4165

Other practice location 1

600 N Wolfe St
Baltimore, MD 21287-0005
Phone (410) 955-9441

Other identifiers 3

IdentifierTypeStateIssuer
CD6086OtherMDRRMC
017863052MedicaidDC
798591600MedicaidMD

Other names 1

  • JHU - PLASTIC SURGERY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031215000719 MD Part B Supplier - Clinic/Group Practice 8921903147 Receives reassigned benefits from 4,764 practitioners
This NPI is an additional NPI on the enrollment
O20240328001521 DC Part B Supplier - Hospital Department(S) 1052223229 Receives reassigned benefits from 5 practitioners
Practice locations: Washington, DC

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

National Provider Directory

National Provider Directory
Part of
Johns Hop Univ Inter Me

Practitioners & affiliated clinicians

Practitioners 82

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 82

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743984000000",
    "number": "1275515546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64165",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242735",
            "telephone_number": "410-550-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Wolfe St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870005",
            "country_code": "US",
            "telephone_number": "410-955-9441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOHNS HOPKINS UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHNS HOPKINS UNIVERSITY",
        "enumeration_date": "2005-11-14",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "SHAVONDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR PRODUCTION UNIT MGR",
        "authorized_official_telephone_number": "410-933-6430"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "CD6086",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017863052",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "798591600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JHU - PLASTIC SURGERY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JHU - PLASTIC SURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.