Individual provider Active NPI

Mark Dwight Whitaker, M.D.

  • Vascular & Interventional Radiology Physician
  • Owings Mills, MD
National Provider Identifier
1366414112
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
D0050635 Issued in MD
Practice address
21 Crossroads Dr
Ste 100
Owings Mills, MD 21117-5441
Phone
(410) 356-8186
Fax
(410) 356-4180
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X D0050635 MD
Vascular & Interventional Radiology Physician 2085R0204X D0050635 MD Primary

Addresses

Primary practice location

21 Crossroads Dr
Ste 100
Owings Mills, MD 21117-5441

Mailing address

10373A Reisterstown Rd
Owings Mills, MD 21117-3617
Phone (410) 356-8186

Other identifiers 3

IdentifierTypeStateIssuer
2849OtherDCB/C B/S
J062OtherMDB/C B/S
KA80OtherMDB/C B/S

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
I20110316000828 MD Practitioner - Diagnostic Radiology 6901704493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Howard University College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Imaging Network PCGroup PAC ID 6103259304, 79 clinicians

Practice addresses (Care Compare)

130 Hospital Rd
Suite Ll100
Prince Frederick, MD 20678-4029
Phone (410) 535-4111

Merit-based Incentive Payment System (MIPS)

Final score
85.95 of 100Reported as group
Quality
75
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0050635MDMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Imaging Network PC Diagnostic Radiology CurrentSince Mar 1, 2020 Accepting new patients
Nanticoke Radiology, LLC Diagnostic Radiology Past Accepting new patients

Locations

130 Hospital Rd
Ste LL100
Prnc Frederck, MD 20678
Phone (410) 535-4111

10400 Odonnell Pl
Ste 100
Waldorf, MD 20603
Phone (401) 298-0454

Organizations & group practices 3

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366414112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10373A REISTERSTOWN RD",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173617",
            "telephone_number": "410-356-8186",
            "fax_number": "410-356-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CROSSROADS DR",
            "address_2": "STE 100",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175441",
            "telephone_number": "410-356-8186",
            "fax_number": "410-356-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "MARK",
        "middle_name": "DWIGHT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0050635",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MD",
            "license": "D0050635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/C B/S",
            "identifier": "2849",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/C B/S",
            "identifier": "J062",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/C B/S",
            "identifier": "KA80",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.