Individual provider Active NPI

Edward A. Seidel, MD

  • Emergency Medicine Physician
  • Baltimore, MD
National Provider Identifier
1477582021
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D38956 Issued in MD
Practice address
5601 Loch Raven Blvd
Baltimore, MD 21239-2905
Phone
(410) 532-4040
Fax
(410) 532-5957
NPI assigned
Jul 3, 2006
Last updated
Jul 17, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D38956 MD Primary

Addresses

Primary practice location

5601 Loch Raven Blvd
Baltimore, MD 21239-2905

Mailing address

307 S Evergreen Ave
Woodbury, NJ 08096-2739
Phone (856) 686-4300

Other identifiers 1

IdentifierTypeStateIssuer
765210000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, TX, DC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040921001203 MD Practitioner - Internal Medicine 0547238131 Reassigns benefits to 2 organizations
I20150825003222 TX Practitioner - Emergency MedicinePractitioner - Internal Medicine 0547238131 Reassigns benefits to 5 organizations
I20241113002086 DC Practitioner - Internal Medicine 0547238131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Call Medical Center LLCGroup PAC ID 5496091290, 28 clinicians
Centennial Medical Group, PAGroup PAC ID 2668466038, 34 clinicians

Practice addresses (Care Compare)

10981 Johns Hopkins Rd
Laurel, MD 20723-6002
Phone (410) 694-7999

15646 Old Columbia Pike
Burtonsville, MD 20866-1630
Phone (301) 421-1214

6250 Old Dolbbin Lane
Columbia, MD 21045-5816
Phone (410) 730-3399

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D38956MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Hospitalist Associates, LLC CurrentSince Mar 1, 2016 Accepting new patients
Centennial Medical Group, PA Emergency Medicine Current Accepting new patients
Centennial Medical Group, PA CurrentSince Sep 2, 2024 Accepting new patients
Victoria Emergency Associates LLC Emergency Medicine CurrentSince Mar 8, 2016 Accepting new patients
Seminole Hospital District of Gaines County Texas CurrentSince Jul 29, 2017 Accepting new patients
Centennial Medical Group, PA CurrentSince Sep 2, 2024 Accepting new patients
Ess of Nacogdoches LLC Emergency Medicine CurrentSince May 1, 2019 Accepting new patients
Seminole Hospital District of Gaines County Texas Emergency Medicine CurrentSince Jul 29, 2017 Accepting new patients
First Call Medical Center LLC Current Accepting new patients
Ess of Port Lavaca LLC Emergency Medicine CurrentSince Jul 3, 2017 Accepting new patients
First Call Medical Center LLC CurrentSince Sep 2, 2024 Accepting new patients
First Call Medical Center LLC CurrentSince Sep 2, 2024 Accepting new patients
Atlantic Physician Services of Maryland, PC Past Accepting new patients

Locations

15646 Old Columbia Pike
Burtonsville, MD 20866
Phone (301) 421-1214

6230 Old Dobbin Ln
Ste 230
Columbia, MD 21045
Phone (443) 312-2111

6250 Old Dobbin Ln
Columbia, MD 21045

10120 Baltimore National Pike
Ellicott City, MD 21042
Phone (410) 694-7999

10981 Johns Hopkins Rd
Laurel, MD 20723
Phone (410) 694-7999

2008 Nine Rd
Brady, TX 76825
Phone (325) 597-2901

1204 N Mound St
Nacogdoches, TX 75961
Phone (936) 564-4611

815 N Virginia St
Port Lavaca, TX 77979
Phone (361) 552-0325

209 NW 8th St
Seminole, TX 79360
Phone (432) 758-5811

506 E San Antonio St
Victoria, TX 77901
Phone (361) 575-1445

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1477582021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739",
            "telephone_number": "856-686-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392905",
            "telephone_number": "410-532-4040",
            "fax_number": "410-532-5957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIDEL",
        "first_name": "EDWARD",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D38956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "765210000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.