Individual provider Active NPI

Elias Camille Ghandour, M.D.

  • Nephrology Physician
  • Baltimore, MD
National Provider Identifier
1306842059
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
D0035706 Issued in MD
Practice address
5601 Loch Raven Blvd
Ste 3
Baltimore, MD 21239-2905
Phone
(443) 444-3775
Fax
(443) 444-4678
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X D0035706 MD Primary

Addresses

Primary practice location

5601 Loch Raven Blvd
Ste 3
Baltimore, MD 21239-2905

Mailing address

5601 Loch Raven Blvd
Ste 3 N
Baltimore, MD 21239-2905
Phone (443) 444-3775

Other identifiers 2

IdentifierTypeStateIssuer
52322301OtherMDBLUE SHIELD
206901200MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080509000386 MD Practitioner - NephrologyPractitioner - Internal Medicine 2961419668 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Nephrology Center of Maryland, PAGroup PAC ID 1153395306, 16 clinicians
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

5601 Lloch Raven Blvd
Baltimore, MD 21239-2945
Phone (443) 444-3775

Hospital & facility affiliations

  • DaVita Good Samaritan Dialysis Dialysis facility, Baltimore, MD, CCN 212722
  • DaVita Timonium Dialysis Dialysis facility, Lutherville Timonium, MD, CCN 212738
  • DaVita Dulaney Towson Dialysis Center Dialysis facility, Towson, MD, CCN 212612
  • FMC - Greater Baltimore Dialysis facility, Baltimore, MD, CCN 212531
  • Concerto Maryland, LLC Dialysis facility, Port Deposit, MD, CCN 212687
  • Medstar Good Samaritan Hospital Hospital, Baltimore, MD, CCN 210056
  • Medstar Union Memorial Hospital Hospital, Baltimore, MD, CCN 210024
  • 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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0035706MDMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Center of Maryland, PA Nephrology CurrentSince Jun 19, 2010 Accepting new patients
Johns Hopkins University CurrentSince Jul 26, 2007 Accepting new patients
Johns Hopkins University Current Accepting new patients
Johns Hopkins University Nephrology CurrentSince Jul 26, 2007 Accepting new patients

Locations

5601 Loch Raven Blvd
#401
Baltimore, MD 21239
Phone (410) 532-4624

5601 Loch Raven Blvd
#3N
Baltimore, MD 21239
Phone (410) 532-3775

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

5601 Loch Raven Blvd
Fl 3
Northwood, MD 21239
Phone (410) 532-3775

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7494/brand/1/csg/1/fhir/r4
  • Direct secure messaging: elias.ghandour.1@7494.direct.athenahealth.com
  • Direct secure messaging: eghandour121634@direct.hopkinsmedicine.org

Organizations & group practices 4

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.

Hospital & facility affiliations 10

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1306842059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "STE 3 N",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392905",
            "telephone_number": "443-444-3775",
            "fax_number": "443-444-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "STE 3",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392905",
            "telephone_number": "443-444-3775",
            "fax_number": "443-444-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANDOUR",
        "first_name": "ELIAS",
        "middle_name": "CAMILLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": "D0035706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "52322301",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206901200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.