Individual provider Active NPI

George Hennawi, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Baltimore, MD
National Provider Identifier
1336140524
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
D0059479 Issued in MD
Practice address
5601 Loch Raven
Russell Morgan
Baltimore, MD 21239
Phone
(443) 444-4720
Fax
(443) 444-4720
NPI assigned
Aug 10, 2005
Last updated
Feb 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X D0059479 MD Primary
Internal Medicine Physician 207R00000X D0059479 MD

Addresses

Primary practice location

5601 Loch Raven
Russell Morgan
Baltimore, MD 21239

Mailing address

5601 Loch Raven Blvd
Suite 412 Russell Morgan Building
Baltimore, MD 21239-2945
Phone (443) 444-4720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070216000291 MD Practitioner - Geriatric MedicinePractitioner - Internal Medicine 9830291145 Reassigns benefits to 2 organizations
I20190715002210 DC Practitioner - Geriatric MedicinePractitioner - Internal Medicine 9830291145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians
Medstar Total Elder Care, LLCGroup PAC ID 4981901550, 27 clinicians

Practice addresses (Care Compare)

1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440

201 E University Pkwy
Baltimore, MD 21218-2829
Phone (410) 554-2000

3304 Guilford Ave
Baltimore, MD 21218-2829
Phone (410) 554-6740

5601 Lloch Raven Blvd
Baltimore, MD 21239-2945
Phone (410) 581-1200

5601 Loch Raven Blvd
Suite 412
Baltimore, MD 21239-2949
Phone (443) 444-6100

5601 Loch Raven Blvd Russel
Ste2
Baltimore, MD 21239-2945
Phone (443) 444-5600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0059479MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2021 Accepting new patients
Medstar Medical Group II LLC Internal Medicine CurrentSince Dec 1, 2021 Accepting new patients
Medstar Total Elder Care LLC CurrentSince Dec 1, 2020 Accepting new patients
Upmc Western Maryland Health Services, LLC Internal Medicine Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

5445 Loch Raven Blvd
Ste 203
Baltimore, MD 21239
Phone (443) 444-6100

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

5601 Loch Raven Blvd
Ste 412
Baltimore, MD 21239
Phone (443) 444-4720

18101 Prince Philip Dr
Olney, MD 20832
Phone (301) 774-8618

17340 Quaker Ln
Sandy Spring, MD 20860
Phone (301) 774-2201

6569 N Charles St
Ste 307
Towson, MD 21204
Phone (443) 849-2767

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1336140524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "SUITE 412 RUSSELL MORGAN BUILDING",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392945",
            "telephone_number": "443-444-4720",
            "fax_number": "443-444-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN",
            "address_2": "RUSSELL MORGAN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21239",
            "telephone_number": "443-444-4720",
            "fax_number": "443-444-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNAWI",
        "first_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D0059479",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0059479",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.