Individual provider Active NPI

Marian Raben, P.A.-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1306268966
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0000998 Issued in MD
Practice address
1650 Orleans St
CRB I 1M 50-a
Baltimore, MD 21287-0013
Phone
(410) 502-3421
Fax
(410) 614-8160
NPI assigned
Jan 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0000998 MD Primary

Addresses

Primary practice location

1650 Orleans St
CRB I 1M 50-a
Baltimore, MD 21287-0013

Mailing address

1650 Orleans St
CRB I 1M 50-a
Baltimore, MD 21287-0013
Phone (410) 502-3421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0000998MDMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1306268966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 ORLEANS ST",
            "address_2": "CRB I 1M 50-A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870013",
            "telephone_number": "410-502-3421",
            "fax_number": "410-614-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 ORLEANS ST",
            "address_2": "CRB I 1M 50-A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870013",
            "telephone_number": "410-502-3421",
            "fax_number": "410-614-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABEN",
        "first_name": "MARIAN",
        "name_prefix": "Ms.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0000998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.