Individual provider Active NPI

Richard Bacharach, MD

  • Psychiatry Physician
  • Ellicott City, MD
National Provider Identifier
1306852439
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0021489 Issued in MD
Practice address
4801 Dorsey Hall Dr
Suite 200
Ellicott City, MD 21042
Phone
(410) 715-1180
Fax
(410) 715-1182
NPI assigned
Jul 31, 2006
Last updated
Feb 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D0021489 MD Primary
Child & Adolescent Psychiatry Physician 2084P0804X D0021489 MD

Addresses

Primary practice location

4801 Dorsey Hall Dr
Suite 200
Ellicott City, MD 21042

Mailing address

4801 Dorsey Hall Dr
Suite 200
Ellicott City, MD 21042
Phone (410) 715-1180

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
I20081007000129 MD Practitioner - Psychiatry 1850469933 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0021489MDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Bacharach, Volkman and Associates, L.L.C. Psychiatry CurrentSince Dec 31, 1997 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5005 Signal Bell Ln
Ste 206
Clarksville, MD 21029
Phone (410) 715-1180

5450 Knoll North Dr
Ste 100
Columbia, MD 21045
Phone (410) 601-1800

4801 Dorsey Hall Dr
Ste 200
Ellicott City, MD 21042
Phone (410) 715-1180

Organizations & group practices 2

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1306852439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR",
            "address_2": "SUITE 200",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21042",
            "telephone_number": "410-715-1180",
            "fax_number": "410-715-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR",
            "address_2": "SUITE 200",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21042",
            "telephone_number": "410-715-1180",
            "fax_number": "410-715-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACHARACH",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0021489",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D0021489",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.