Individual provider Active NPI

Samantha Consoli

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1487253738
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
620 W Lexington St Ste 5110
Baltimore, MD 21201-1508
Phone
(410) 777-1881
NPI assigned
Oct 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

620 W Lexington St Ste 5110
Baltimore, MD 21201-1508

Mailing address

620 W Lexington St Ste 5110
Baltimore, MD 21201-1508
Phone (410) 777-1881

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
I20230527000074 MD Practitioner - Physician Assistant 1759748296 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Dermatology of Maryland, LLCGroup PAC ID 5496120933, 2 clinicians

Practice addresses (Care Compare)

2568 A Riva Rd
Suite 102
Annapolis, MD 21401-7457
Phone (410) 216-0993

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
First Call Medical Center LLC Current Accepting new patients
First Call Medical Center LLC CurrentSince May 1, 2023 Accepting new patients

Locations

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

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1487253738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W LEXINGTON ST STE 5110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011508",
            "telephone_number": "410-777-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W LEXINGTON ST STE 5110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011508",
            "telephone_number": "410-777-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSOLI",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.