Individual provider Active NPI

Wendy Jo Subasic, PA

  • Medical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1427107580
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MD0003372 Issued in MD
Practice address
3407 Wilkens Ave
Suite 210
Baltimore, MD 21229-5072
Phone
(410) 644-0929
NPI assigned
Jan 9, 2007
Last updated
Apr 29, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MD0003372 MD Primary

Addresses

Primary practice location

3407 Wilkens Ave
Suite 210
Baltimore, MD 21229-5072

Mailing address

25 Crossroads Dr
Suite 306
Owings Mills, MD 21117-5421
Phone (443) 738-2872

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070911000704 MD Practitioner - Physician Assistant 5698868354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chesapeake Urology Associates LLCGroup PAC ID 4789673393, 161 clinicians

Practice addresses (Care Compare)

1838 Greene Tree Rd
Suite 460
Baltimore, MD 21208-7113
Phone (410) 581-8140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MD0003372MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Urology Associates, LLC CurrentSince May 31, 2013 Accepting new patients
Chesapeake Urology Associates LLC CurrentSince May 31, 2013 Accepting new patients
Caton Emergency Physicians Past Accepting new patients
Maryland Provo-I Medical Services, PC Past Accepting new patients
Chesapeake Urology Associates, LLC Past Accepting new patients
Champion Emergency Physicians LLC Past Accepting new patients
Johns Hopkins Emergency Medical Past Accepting new patients

Locations

3407 Wilkens Ave
Ste 210
Baltimore, MD 21229
Phone (410) 644-0929

25 Crossroads Dr
Ste 306
Owings Mills, MD 21117
Phone (443) 231-1681

1838 Greene Tree Rd
Ste 460
Pikesville, MD 21208
Phone (410) 581-8140

Interoperability endpoints

  • Direct secure messaging: wendysubasic@tsicua.allscriptsdirect.net

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1427107580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CROSSROADS DR",
            "address_2": "SUITE 306",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175421",
            "telephone_number": "443-738-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 WILKENS AVE",
            "address_2": "SUITE 210",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295072",
            "telephone_number": "410-644-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBASIC",
        "first_name": "WENDY",
        "middle_name": "JO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "MD0003372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.