NPIMap

Organization Active NPI

Overcare Health Services LLC

  • Primary Care Clinic/Center
  • Baltimore, MD
National Provider Identifier
1346077922
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
OVERCARE HEALTH SERVICES LLC
Practice address
2245 Eastern Ave
Baltimore, MD 21231-3113
Phone
(443) 489-9009
Fax
(443) 489-9008
NPI assigned
Sep 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Charles WanguiNPI 1861034159
Title
Owner
Phone
(443) 489-9009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2245 Eastern Ave
Baltimore, MD 21231-3113

Mailing address

2245 Eastern Ave
Baltimore, MD 21231-3113
Phone (443) 489-9009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241030004220 MD Part B Supplier - Clinic/Group Practice 6507254398 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Overcare Health Services LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1346077922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212313113",
            "telephone_number": "443-489-9009",
            "fax_number": "443-489-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212313113",
            "telephone_number": "443-489-9009",
            "fax_number": "443-489-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERCARE HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "WANGUI",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-489-9009"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 17, 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.