Individual provider Active NPI

Michael Jonathan Brown, MD

  • Psychiatry Physician
  • Ellicott City, MD
National Provider Identifier
1407199375
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0234 Issued in MD
Practice address
5114 Dorsey Hall Dr Ste 2
Ellicott City, MD 21042-7878
Phone
(410) 995-8078
NPI assigned
Mar 29, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0234 MD Primary

Addresses

Primary practice location

5114 Dorsey Hall Dr Ste 2
Ellicott City, MD 21042-7878

Mailing address

5114 Dorsey Hall Dr Ste 2
Ellicott City, MD 21042-7878
Phone (410) 995-8078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 9, 2019 through Oct 9, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0234MDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Anxiety and Depression Treatment Center CurrentSince Oct 16, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5114 Dorsey Hall Dr
Ste 2
Ellicott City, MD 21042
Phone (410) 995-8078

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.

NPI Registry JSON

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1407199375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5114 DORSEY HALL DR STE 2",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427878",
            "telephone_number": "410-995-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5114 DORSEY HALL DR STE 2",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427878",
            "telephone_number": "410-995-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MICHAEL",
        "middle_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-29",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "0234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.