NPIMap

Organization Active NPI

Chesapeake Open MRI L L C

Doing business as Chesapeake Medical Imaging

  • Diagnostic Radiology Physician
  • Easton, MD
National Provider Identifier
1417128448
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CHESAPEAKE OPEN MRI L L C
Doing business as
Chesapeake Medical Imaging
Practice address
401 Purdy St
Easton, MD 21601-4060
Phone
(410) 822-1888
NPI assigned
Mar 18, 2008
Last updated
Sep 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CHESAPEAKE OPEN MRIAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Authorized official

Name
Mark D Baganz, M.D.
Title
President
Phone
(410) 822-1888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

401 Purdy St
Easton, MD 21601-4060

Mailing address

122 Defense Hwy Ste 102
Annapolis, MD 21401-7044
Phone (302) 526-1604

Other identifiers 3

IdentifierTypeStateIssuer
408127700MedicaidMD
F855OtherDCBLUE SHIELD
LX26CHOtherMDBLUE SHIELD

Other names 1

  • Chesapeake Medical Imaging Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080422000350 MD Part B Supplier - Clinic/Group Practice 9931178373 Receives reassigned benefits from 24 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Easton, MD; Eldersburg, MD; Fulton, MD; Glen Burnie, MD; Lutherville, MD; Stevensville, MD; Chestertown, MD; Columbia, MD…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Part of
Chesapeake Open MRI LLC

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1417128448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 DEFENSE HWY STE 102",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017044",
            "telephone_number": "302-526-1604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PURDY ST",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216014060",
            "telephone_number": "410-822-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE OPEN MRI L L C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHESAPEAKE OPEN MRI",
        "enumeration_date": "2008-03-18",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "BAGANZ",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-822-1888",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408127700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "F855",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "LX26CH",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chesapeake Medical Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Easton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.