Samir Gautam, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

D77622 Issued in MD

Practice address

1830 E Monument St Ste 416
Baltimore, MD 21287-0020

Phone

(410) 955-5268

Fax

(410) 367-2258

NPI assigned

Aug 24, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD, DC2 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

Specialty

Critical Care (Intensivists)Also: Internal Medicine, Nephrology

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fresenius Kidney Care Caroline Street Dialysis facility, Baltimore, MD, CCN 212707
• Fresenius Kidney Care Fleet Street Dialysis facility, Baltimore, MD, CCN 212708
• Johns Hopkins Hospital, the Hospital, Baltimore, MD, CCN 210009
• Johns Hopkins Bayview Medical Center Hospital, Baltimore, MD, CCN 210029
• Medstar Franklin Square Medical Center Hospital, Rosedale, MD, CCN 210015
• Sibley Memorial Hospital Hospital, Washington, DC, CCN 090005

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgautam542651@direct.hopkinsmedicine.org

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.

• Johns Hopkins University

  • Pain Medicine (Anesthesiology) Physician
  • Baltimore, MD
  • NPI 1922008549
  Medicare reassignment Care Compare group NPD
• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187
  Medicare reassignment Care Compare group NPD
• Medical Faculty Associates, Inc

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1417990581
  Medicare reassignment NPD
• Johns Hopkins University

  • Ophthalmology Physician
  • Belcamp, MD
  • NPI 1376342774
  NPD
• Johns Hopkins University

  • Nephrology Physician
  • Baltimore, MD
  • NPI 1376537456
  NPD
• Medstar Medical Group II LLC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1376887844
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baltimore County Dialysis, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Baltimore, MD
  • NPI 1053772079

  Dialysis facility

  Care Compare affiliation Name & address match
• Baltimore County Dialysis, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Baltimore, MD
  • NPI 1689035693

  Dialysis facility

  Care Compare affiliation Name & address match
• Franklin Square Hospital Center, Inc

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1184712085
  Care Compare affiliation
• Johns Hopkins Bayview Medical Center Inc

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1790700904
  Care Compare affiliation
• Johns Hopkins Bayview Medical Center, Inc.

  • Chronic Disease Hospital
  • Baltimore, MD
  • NPI 1336251412
  Care Compare affiliation
• The Johns Hopkins Hospital

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1578597993
  Care Compare affiliation
• Lucy Webb Hayes National Training School for Deaconesses & Missionarie

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1366492977
  Care Compare affiliation

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1275766396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 E MONUMENT ST STE 416",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870020",
            "telephone_number": "410-955-5268",
            "fax_number": "410-367-2258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Jefferson Davis Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Natchez",
            "state": "MS",
            "postal_code": "391205120",
            "country_code": "US",
            "telephone_number": "601-273-3554",
            "fax_number": "601-653-9589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAUTAM",
        "first_name": "SAMIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-24",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "MD20786",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": "D77622",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "23889",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2434187",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04931327",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Priyanka Gaur
• Shivani Gaur
• Heather M Gausepohl
• Adarsha Gautam
• Rishi Gautam, M.D.
• Ujwal Gautam, MD
• Sakthi Swaroopini Gautham, M.D.
• Angela Gauthier
• Gary Christopher Gauthier, C.R.N.A.
• Jessica Gauthier, LCSW-C

• Nephrology Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Nephrology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.