Metro Xtracare P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

D15720816 Issued in MD

Legal business name

METRO XTRACARE P.C.

Practice address

3608 Milford Mill Rd
Windsor Mill, MD 21244-3328

Phone

(443) 272-7858

NPI assigned

Oct 31, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Babajide O Runsewe, MDNPI 1124220561

Title

President

Phone

(443) 272-7858

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10109/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Babajide Runsewe, MD

  • Family Medicine Physician
  • Windsor Mill, MD
  • NPI 1124220561

  MD

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688256000000",
    "number": "1477958429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3608 MILFORD MILL RD",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212443328",
            "telephone_number": "443-272-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3608 MILFORD MILL RD",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212443328",
            "telephone_number": "443-272-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO XTRACARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-31",
        "last_updated": "2023-07-02",
        "certification_date": "2023-07-02",
        "status": "A",
        "authorized_official_last_name": "RUNSEWE",
        "authorized_official_first_name": "BABAJIDE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "443-272-7858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MD",
            "license": "D15720816",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "MD",
            "license": "D15720816",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Windsor Mill, MD
• Primary Care Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.