Individual provider Active NPI

Livingstone Sidney Dore Jr., M.D.

  • Surgery Physician
  • Towson, MD
National Provider Identifier
1386087377
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D0086880 Issued in MD
Practice address
7601 Osler Dr
Towson, MD 21204-7700
Phone
(410) 427-2024
NPI assigned
Apr 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X D0086880 MD Primary

Addresses

Primary practice location

7601 Osler Dr
Towson, MD 21204-7700

Mailing address

900 Elkridge Landing Rd FL 2
Linthicum, MD 21090-2924
Phone (804) 387-3949

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
I20190906000155 MD Practitioner - General Surgery 1557619616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Maryland School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7505 Osler Dr
Suite 303
Towson, MD 21204-7738
Phone (410) 427-2024

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)12
Hernia repair (minimally invasive)23
Upper gastrointestinal (GI) endoscopy for acid reflux15
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0086880MDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Aug 15, 2019 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Aug 15, 2019 Accepting new patients

Locations

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

25 Crossroads Dr
Ste 400
Owings Mills, MD 21117
Phone (410) 356-6664

7505 Osler Dr
Towson, MD 21204
Phone (410) 337-0557

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

7505 Osler Dr
Ste 303
Towson, MD 21204
Phone (410) 427-2024

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.

Hospital & facility affiliations 1

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": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1386087377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ELKRIDGE LANDING RD FL 2",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902924",
            "telephone_number": "804-387-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 OSLER DR",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047700",
            "telephone_number": "410-427-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORE",
        "first_name": "LIVINGSTONE",
        "middle_name": "SIDNEY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-10",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0086880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.