Organization Active NPI

Endoscopy Center of North Baltimore LLC

  • Ambulatory Surgical Clinic/Center
  • Towson, MD
National Provider Identifier
1417987595
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
A1385 Issued in MD
Legal business name
ENDOSCOPY CENTER OF NORTH BALTIMORE LLC
Practice address
1220C E Joppa Rd
Suite A508
Towson, MD 21286-5814
Phone
(410) 296-4415
Fax
(410) 296-4417
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Authorized official

Name
Jonathan Bailey
Title
Officer / Ao
Phone
(203) 609-1168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X A1385 MD Primary

Addresses

Primary practice location

1220C E Joppa Rd
Suite A508
Towson, MD 21286-5814

Mailing address

1220C E Joppa Rd
Suite A508
Towson, MD 21286-5814
Phone (410) 296-4415

Other identifiers 1

IdentifierTypeStateIssuer
402893700MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000350 MD Part B Supplier - Ambulatory Surgical Center 2264346584 Practice locations: Towson, MD

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Endoscopy Center of North BaltimoreCCN 21C0001385
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Endoscopy Center of North Baltlimore2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1220C E Joppa Rd
Ste 508
Towson, MD 21286
Phone (410) 296-4415

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1417987595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220C E JOPPA RD",
            "address_2": "SUITE A508",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865814",
            "telephone_number": "410-296-4415",
            "fax_number": "410-296-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220C E JOPPA RD",
            "address_2": "SUITE A508",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865814",
            "telephone_number": "410-296-4415",
            "fax_number": "410-296-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOSCOPY CENTER OF NORTH BALTIMORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OFFICER / AO",
        "authorized_official_telephone_number": "203-609-1168"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402893700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.