Individual provider Active NPI

Zachary Raymond Wynne, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Baltimore, MD
National Provider Identifier
1417583436
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
D0105490 Issued in MD
Practice address
22 S Greene St RM N3E09
Baltimore, MD 21201-1544
Phone
(570) 994-4520
NPI assigned
Mar 21, 2020
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D0105490 MD
Critical Care Medicine (Internal Medicine) Physician 207RC0200X D0105490 MD Primary

Addresses

Primary practice location

22 S Greene St RM N3E09
Baltimore, MD 21201-1544

Mailing address

22 S Greene St RM N3E09
Baltimore, MD 21201-1544
Phone (410) 328-6110

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
I20201103000385 MD Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 6204246283

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Critical Care (Intensivists), Pulmonary Disease
Education
Pennsylvania State University College of Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

110 S Paca St
08 153
Baltimore, MD 21201-1642

PO Box
Suite 64442
Baltimore, MD 21264

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1584748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1417583436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST RM N3E09",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST RM N3E09",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "570-994-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNNE",
        "first_name": "ZACHARY",
        "middle_name": "RAYMOND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-21",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0105490",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MD",
            "license": "D0105490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.