Individual provider Active NPI

Olga M P. Rossello, M.D.

  • Psychiatry Physician
  • Lutherville, MD
National Provider Identifier
1326218371
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0042563 Issued in MD
Practice address
101 W Ridgely Rd
Suite 7a
Lutherville, MD 21093-5101
Phone
(240) 292-1196
Fax
(410) 825-0513
NPI assigned
Mar 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D0042563 MD Primary

Addresses

Primary practice location

101 W Ridgely Rd
Suite 7a
Lutherville, MD 21093-5101

Mailing address

101 W Ridgely Rd
Suite 7a
Lutherville, MD 21093-5101
Phone (240) 292-1196

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081204000041 MD Practitioner - PsychiatryPractitioner - Addiction Medicine 4385705706 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0042563MDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comptroller of Maryland Central Payroll Bureau Current Accepting new patients
Glass Health Systems, LLC Psychiatry Past Accepting new patients

Locations

300 W Preston St
Ste 402
Baltimore, MD 21201
Phone (410) 767-2940

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1326218371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W RIDGELY RD",
            "address_2": "SUITE 7A",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210935101",
            "telephone_number": "240-292-1196",
            "fax_number": "410-825-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W RIDGELY RD",
            "address_2": "SUITE 7A",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210935101",
            "telephone_number": "240-292-1196",
            "fax_number": "410-825-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "P. ROSSELLO",
        "first_name": "OLGA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-05",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0042563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; 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.