Individual provider Active NPI

Ulysses Grant Gardner Jr., MD, MBA

  • Radiation Oncology Physician
  • Baltimore, MD
National Provider Identifier
1437784691
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
W4471 Issued in TX
Practice address
401 N Broadway St Ste 1440
Baltimore, MD 21287-0019
Phone
(410) 955-7390
NPI assigned
Mar 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X W4471 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

401 N Broadway St Ste 1440
Baltimore, MD 21287-0019

Mailing address

401 N Broadway St Ste 1440
Baltimore, MD 21287-0019

Other practice location 1

2115 Leiter Rd
Miamisburg, OH 45342-3600
Phone (937) 384-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20260401002868 TX Practitioner - Radiation Oncology 0143639922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Wright State University Boonshoft School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Dallas, TX 75265

PO Box
650859 Dept. 710
Dallas, TX 75265-0859

Hospital & facility affiliations

  • Johns Hopkins Hospital, the Hospital, Baltimore, MD, CCN 210009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
W4471TXMDRadiation Oncology Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1437784691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N BROADWAY ST STE 1440",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N BROADWAY ST STE 1440",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870019",
            "telephone_number": "410-955-7390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2115 Leiter Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453423600",
            "country_code": "US",
            "telephone_number": "937-384-6800",
            "fax_number": "937-384-6938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "ULYSSES",
        "middle_name": "GRANT",
        "name_suffix": "Jr.",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-09",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "W4471",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.