NPIMap

Individual provider Active NPI

Matthew Park, M.D.

  • Pulmonary Disease Physician
  • Glen Burnie, MD
National Provider Identifier
1437114451
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
D0047575 Issued in MD
Practice address
305 Hospital Dr
Suite 305 Tate Center
Glen Burnie, MD 21061-5805
Phone
(410) 768-3701
Fax
(410) 766-0881
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X D0047575 MD Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X D47575 MD
Infectious Disease Physician 207RI0200X D47575 MD

Addresses

Primary practice location

305 Hospital Dr
Suite 305 Tate Center
Glen Burnie, MD 21061-5805

Mailing address

305 Hospital Dr
Suite 305 Tate Center
Glen Burnie, MD 21061-5805
Phone (410) 768-3701

Other identifiers 1

IdentifierTypeStateIssuer
405189100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040726000471 MD Practitioner - Pulmonary DiseasePractitioner - Infectious DiseasePractitioner - Critical Care (Intensivists) 5395725600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Infectious Disease
Education
University of Maryland School of Medicine, 1993
Medicare assignment
May accept Medicare assignment
Group practices
Sinai Hospital of Baltimore, IncGroup PAC ID 0941112346, 373 clinicians

Practice addresses (Care Compare)

2401 E Belvedere Ave
Baltimore, MD 21215-5216
Phone (410) 601-9000

Hospital & facility affiliations

  • Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012
  • Levindale Hebrew Geriatric Center and Hospital Hospital, Baltimore, MD, CCN 210064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D47575MDMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore, Inc Pulmonary Disease CurrentSince May 20, 2019 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince May 20, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Sinai Hospital of Baltimore Inc Critical Care Medicine Past Accepting new patients
Baltimore Washington Medical Center Inc. Critical Care Medicine Past Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

2411 W Belvedere Ave
Ste 401
Baltimore, MD 21215
Phone (410) 578-1094

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 3

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1437114451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 HOSPITAL DR",
            "address_2": "SUITE 305 TATE CENTER",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615805",
            "telephone_number": "410-768-3701",
            "fax_number": "410-766-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 HOSPITAL DR",
            "address_2": "SUITE 305 TATE CENTER",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615805",
            "telephone_number": "410-768-3701",
            "fax_number": "410-766-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MD",
            "license": "D0047575",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MD",
            "license": "D47575",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MD",
            "license": "D47575",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405189100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.