Individual provider Active NPI

Maciej Poltorak, M.D.

  • Neurology Physician
  • Greenbelt, MD
National Provider Identifier
1427064229
Registry record updated Jun 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
D54821 Issued in MD
Practice address
7500 Hanover Pkwy
Suite 201
Greenbelt, MD 20770-2010
Phone
(301) 982-7944
Fax
(301) 441-8696
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X D54821 MD Primary

Addresses

Primary practice location

7500 Hanover Pkwy
Suite 201
Greenbelt, MD 20770-2010

Mailing address

7500 Hanover Pkwy
Suite 201
Greenbelt, MD 20770-2010
Phone (301) 982-7944

Other identifiers 6

IdentifierTypeStateIssuer
0500456OtherMDUNITED HEALTHCARE
16540016OtherMDBCBS DC
699071100MedicaidMD
298214OtherMDMAMSI
528559OtherMDAETNA USHC
H832NEOtherMDBCBS MD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20081121000124 DC Practitioner - Neurology 2365502291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suburban/NRH Medical Rehabilitation IncGroup PAC ID 6507846771, 885 clinicians
Neurological Medicine, P.a.Group PAC ID 2860438041, 5 clinicians

Practice addresses (Care Compare)

6410 Rockledge Dr
Suite 600
Bethesda, MD 20817-1844

7500 Hanover Pkwy
Suite 201
Greenbelt, MD 20770-2009
Phone (301) 982-7944

Merit-based Incentive Payment System (MIPS)

Final score
88.18 of 100Reported as group
Quality
100
Promoting interoperability
95
Improvement activities
40
Cost
64.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D54821MDMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: maciejpoltorak@nmpa.allscriptsdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308182400000",
    "number": "1427064229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 HANOVER PKWY",
            "address_2": "SUITE 201",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207702010",
            "telephone_number": "301-982-7944",
            "fax_number": "301-441-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 HANOVER PKWY",
            "address_2": "SUITE 201",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207702010",
            "telephone_number": "301-982-7944",
            "fax_number": "301-441-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLTORAK",
        "first_name": "MACIEJ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2011-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MD",
            "license": "D54821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0500456",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DC",
            "identifier": "16540016",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "699071100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "298214",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC",
            "identifier": "528559",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "H832NE",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbelt, MD

Sources for this page

Verify at the official NPI Registry.