NPIMap

Organization Active NPI

Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Lexington Park, MD
National Provider Identifier
1487469243
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GREATER BADEN MEDICAL SERVICE INCORPORATED
Practice address
21729 Great Mills Rd Ste C
Lexington Park, MD 20653-3815
Phone
(301) 888-2233
Fax
(301) 997-1489
NPI assigned
Feb 10, 2025
Last updated
Jun 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
Jeffrey A Kurcab
Title
Cfo
Phone
(301) 599-2172

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

21729 Great Mills Rd Ste C
Lexington Park, MD 20653-3815

Mailing address

7450 Albert Rd FL 3
Brandywine, MD 20613-3035
Phone (301) 888-2233

Other names 1

  • Greater Baden Medical Service at Pax River Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250718004172 MD Part A Provider - Federally Qualified Health Center (FQHC) 4981632650 Practice locations: Lexington Park, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487469243. Details of each certification follow.

Federally qualified health center certification: CCN 801017

Legal name
GREATER BADEN MEDICAL SERVICE INCORPORATED
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 26, 2025
Last certification
Jun 26, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
21729 Great Mills Rd
Ste C
Lexington Park, MD 20653-3815

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Greater Baden Medical Service Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

4320 Ammendale Rd
Beltsville, MD 20705
Phone (240) 542-4084

8030 Matthews Rd
Ste 105
Bryans Road, MD 20616
Phone (301) 283-2800

1458 Addison Rd S
Capitol Heights, MD 20743
Phone (301) 324-1500

1458 Addison Rd S
#5
Capitol Heights, MD 20743
Phone (301) 324-1500

3028 Brightseat Rd
Ste 104
Glenarden, MD 20706
Phone (301) 772-6905

5001 Silver Hill Rd
#2
Suitland, MD 20746
Phone (240) 492-2500

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Roxann Cooper Individual Corporate OfficerBoard Member May 1, 2021
Joan F Hepburn Individual Corporate OfficerBoard Member May 1, 2011
Dale E Speake Individual Corporate OfficerBoard Member Feb 1, 1990
Jeffrey a Kurcab Individual Corporate OfficerCfo May 1, 2022 100%
W-2 Managing EmployeeCfo May 1, 2022 100%
Brandon Jones Individual Corporate OfficerChairman Feb 1, 2017
Robert Harold Eaton Individual Corporate OfficerTreasurer Oct 1, 2018
Mary Ann Friis Individual Corporate OfficerVice Chair Oct 1, 2010

Subparts reporting this organization as parent 15

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

View all 15

Practitioners & affiliated clinicians

Practitioners 59

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1487469243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 ALBERT RD FL 3",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133035",
            "telephone_number": "301-888-2233",
            "fax_number": "301-997-1489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21729 GREAT MILLS RD STE C",
            "city": "LEXINGTON PARK",
            "state": "MD",
            "postal_code": "206533815",
            "telephone_number": "301-888-2233",
            "fax_number": "301-997-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER BADEN MEDICAL SERVICE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "KURCAB",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-599-2172"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Baden Medical Service at Pax River",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lexington Park, MD

Sources for this page

Verify at the official NPI Registry.