Active NPI
Adult & Pediatric Urology Group of Maryland LLC
- Urology Physician
- Baltimore, MD
National Provider Identifier
1376681437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- ADULT & PEDIATRIC UROLOGY GROUP OF MARYLAND LLC
- Practice address
- 3455 Wilkens Ave
Suite 100
Baltimore, MD 21229-5213 - Phone
- (410) 646-0330
- Fax
- (410) 644-6182
- NPI assigned
- Feb 2, 2007
- Last updated
- Jan 14, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bridget Mastrounni
- Title
- Practice Administrator
- Phone
- (410) 646-0331
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
3455 Wilkens Ave
Suite 100
Baltimore, MD 21229-5213
Mailing address
3455 Wilkens Ave
Suite 100
Baltimore, MD 21229-5213
Phone (410) 646-0330
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E612 | Other | MD | CAREFIRST FEDERAL ID |
| E612 | Other | MD | BLUE CHOICE GRP. ID |
| 033000100 | Medicaid | MD | |
| 1507AD | Other | MD | CAREFIRST BCBS OF MD ID |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1358121600000",
"number": "1376681437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3455 WILKENS AVE",
"address_2": "SUITE 100",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212295213",
"telephone_number": "410-646-0330",
"fax_number": "410-644-6182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3455 WILKENS AVE",
"address_2": "SUITE 100",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212295213",
"telephone_number": "410-646-0330",
"fax_number": "410-644-6182"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADULT & PEDIATRIC UROLOGY GROUP OF MARYLAND LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-02",
"last_updated": "2013-01-14",
"status": "A",
"authorized_official_last_name": "MASTROUNNI",
"authorized_official_first_name": "BRIDGET",
"authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
"authorized_official_telephone_number": "410-646-0331"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST FEDERAL ID",
"identifier": "E612",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE GRP. ID",
"identifier": "E612",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "033000100",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BCBS OF MD ID",
"identifier": "1507AD",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
- Jonell Adu-Gyamfi
- Nana Yaw Ampaw Adu-Sarkodie, MD, MPH
- Akwasi Ofori Aduboffour, MD
- Dilys Osei Aduboffour, MD
- Adullum Community Healthcare Center, Inc.
- Adult Day Health, Inc. (Maryland Avenue Adult Daycare Center)
- Adult Medical Daycare of Homeland (Adult Medical Daycare of Overlea)
- Advance Adult Day Care L.L.C. (Friendship Adult Medical Day Center)
- Advance Foot Care and Medical Services,LLC
- Advanced Behavioral Health
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.