NPIMap

Organization Active NPI

Saint Paul Place Specialists, Inc.

  • Pulmonary Disease Physician
  • Baltimore, MD
National Provider Identifier
1306887682
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
SAINT PAUL PLACE SPECIALISTS, INC.
Practice address
301 Saint Paul PL
Burk BLDG 321
Baltimore, MD 21202-2102
Phone
(410) 332-9145
Fax
(410) 332-9105
NPI assigned
Jun 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Authorized official

Name
Justin Deibel
Title
Executive Vice President & Cfo
Phone
(410) 659-2905

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RP1001X Primary
Surgical Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363AS0400X

Addresses

Primary practice location

301 Saint Paul PL
Burk BLDG 321
Baltimore, MD 21202-2102

Mailing address

PO Box 64075
Baltimore, MD 21264-4075

Other identifiers 2

IdentifierTypeStateIssuer
S186OtherMDBLUECHOICE
S798OtherMDBC / BS OF MD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031202000084 MD Part B Supplier - Clinic/Group Practice 7719882943 Receives reassigned benefits from 568 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Towson, MD; Baltimore, MD; Randallstown, MD; Pikesville, MD; Lutherville Timonium, MD; Lutherville, MD; Laurel, MD; Glen Burnie, 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
Tax ID family
St Paul Place Nuclear M60 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

7927 Ritchie Hwy
Glen Burnie, MD 21061
Phone (410) 494-9099

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1306887682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64075",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SAINT PAUL PL",
            "address_2": "BURK BLDG 321",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102",
            "telephone_number": "410-332-9145",
            "fax_number": "410-332-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT PAUL PLACE SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "DEIBEL",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "410-659-2905"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHOICE",
            "identifier": "S186",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC / BS OF MD",
            "identifier": "S798",
            "state": "MD"
        }
    ],
    "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 Dec 18, 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.