Individual provider Active NPI

Mark Slidell, M.D., M.P.H.

  • Pediatric Surgery Physician
  • Baltimore, MD
National Provider Identifier
1417198318
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
D95701 Issued in MD
Practice address
1800 Orleans St
Baltimore, MD 21287-0010
Phone
(410) 955-2717
Fax
(443) 769-1287
NPI assigned
Mar 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 036.131065 IL
Pediatric Surgery Physician 2086S0120X MD037127 DC
Pediatric Surgery Physician 2086S0120X D95701 MD Primary

Addresses

Primary practice location

1800 Orleans St
Baltimore, MD 21287-0010

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-6423

Other practice location 1

5841 S Maryland Ave
M/C 4062 C411
Chicago, IL 60637-1447
Phone (773) 702-6175

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
I20221028002129 MD Practitioner - General Practice 7416101308 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD037127DCMDPediatric Surgery Physician
036.131065ILMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Pediatric Surgery CurrentSince Oct 1, 2022 Accepting new patients
Johns Hopkins University Current Accepting new patients
Johns Hopkins University CurrentSince Oct 1, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
The Johns Hopkins Hospital Past Accepting new patients

Locations

1800 Orleans St
Ste 7338
Baltimore, MD 21287

600 N Wolfe St
Baltimore, MD 21287

1800 Orleans St
Baltimore, MD 21287
Phone (410) 502-2037

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: mslidell148543@direct.aahs.org
  • Direct secure messaging: mslidell1029691@direct.hopkinsmedicine.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1417198318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ORLEANS ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870010",
            "telephone_number": "410-955-2717",
            "fax_number": "443-769-1287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave",
            "address_2": "M/C 4062 C411",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371447",
            "country_code": "US",
            "telephone_number": "773-702-6175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLIDELL",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-23",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "IL",
            "license": "036.131065",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "DC",
            "license": "MD037127",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "MD",
            "license": "D95701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.