NPIMap

Organization Active NPI

Calverthealth Medical Group, LLC

  • Surgery Physician
  • Solomons, MD
National Provider Identifier
1285471128
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CALVERTHEALTH MEDICAL GROUP, LLC
Practice address
14090 HG Trueman Rd Ste 2600
Solomons, MD 20688-3151
Phone
(410) 414-4740
Fax
(410) 414-4741
NPI assigned
Jul 9, 2024
Last updated
Jul 10, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CALVERT HEALTH SYSTEM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Authorized official

Name
Carolyn Heithaus
Title
Cfo
Phone
(410) 535-8236

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X
Internal Medicine Physician 207R00000X
Gastroenterology Physician 207RG0100X
Obstetrics & Gynecology Physician 207V00000X
Plastic Surgery Physician 208200000X
Surgery Physician 208600000X Primary
Surgery of the Hand (Surgery) Physician 2086S0105X
Plastic and Reconstructive Surgery Physician 2086S0122X
Vascular Surgery Physician 2086S0129X
Urology Physician 208800000X
Nurse Practitioner 363L00000X
Family Nurse Practitioner 363LF0000X
Women's Health Nurse Practitioner 363LW0102X
Obesity Medicine (Internal Medicine) Physician 207RB0002X

Addresses

Primary practice location

14090 HG Trueman Rd Ste 2600
Solomons, MD 20688-3151

Mailing address

100 Hospital Rd
Prince Frederick, MD 20678-4017
Phone (410) 414-4791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091215000115 MD Part B Supplier - Clinic/Group Practice 2163562695 Receives reassigned benefits from 55 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Prince Frederick, MD; Waldorf, MD; Solomons, MD; North Beach, MD

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1285471128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784017",
            "telephone_number": "410-414-4791",
            "fax_number": "410-535-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14090 HG TRUEMAN RD STE 2600",
            "city": "SOLOMONS",
            "state": "MD",
            "postal_code": "206883151",
            "telephone_number": "410-414-4740",
            "fax_number": "410-414-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVERTHEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALVERT HEALTH SYSTEM, INC.",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "HEITHAUS",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "410-535-8236"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Solomons, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.