Individual provider Active NPI

Gautam Rao, MD

  • Gynecologic Oncology Physician
  • Baltimore, MD
National Provider Identifier
1407930514
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
D72905 Issued in MD
Practice address
22 S Greene St
Suite S3Ax-19
Baltimore, MD 21201-1544
Phone
(667) 214-1302
Fax
(410) 328-3379
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X MD39934 TN
Gynecologic Oncology Physician 207VX0201X D72905 MD Primary

Addresses

Primary practice location

22 S Greene St
Suite S3Ax-19
Baltimore, MD 21201-1544

Mailing address

250 W Pratt St
Suite 880
Baltimore, MD 21201-2423
Phone (667) 214-1302

Other identifiers 2

IdentifierTypeStateIssuer
440080100MedicaidMD
4164064OtherTNBCBS TN

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
I20111017000585 MD Practitioner - Obstetrics/Gynecology 7517983992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Miami, LM Miller School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

419 W Redwood St
Suite 500
Baltimore, MD 21201-7001
Phone (410) 328-6640

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Skin biopsy1-10
Removal of the uterus11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD39934TNMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of MD Obstetrical and Gynecological Asso. PA CurrentSince Aug 28, 2011 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
University of Maryland Medical Center, LLC Past Accepting new patients
Obstetrical and Gynecological Assoc of the University of Maryland PA Past Accepting new patients

Locations

250 W Pratt St
Ste 880
Baltimore, MD 21201

22 S Greene St
Ste S3AX19
Baltimore, MD 21201
Phone (667) 214-1302

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

419 W Redwood St
Ste 500
Baltimore, MD 21201
Phone (410) 328-6640

500 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (443) 643-1000

Interoperability endpoints

  • Direct secure messaging: grao56070@direct.umm.edu

Organizations & group practices 4

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 2

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1407930514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W PRATT ST",
            "address_2": "SUITE 880",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212012423",
            "telephone_number": "667-214-1302",
            "fax_number": "410-328-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "address_2": "SUITE S3AX-19",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "667-214-1302",
            "fax_number": "410-328-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "GAUTAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "TN",
            "license": "MD39934",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "MD",
            "license": "D72905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "440080100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "4164064",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.