Individual provider Active NPI

Carissa Marrie Baker-Smith, M.D.

  • Pediatric Cardiology Physician
  • Wilmington, DE
National Provider Identifier
1508031121
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
C1-0013525 Issued in DE
Practice address
1600 Rockland Rd
Wilmington, DE 19803-3607
Phone
(302) 651-4200
NPI assigned
Apr 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D70988 MD
Pediatric Cardiology Physician 2080P0202X D70988 MD
Pediatric Cardiology Physician 2080P0202X C1-0013525 DE Primary

Addresses

Primary practice location

1600 Rockland Rd
Wilmington, DE 19803-3607

Mailing address

PO Box 191
Rockland, DE 19732-0191
Phone (302) 651-4200

Other practice location 1

201 Towne Centre Dr Ste 500
Dover, DE 19904-4062
Phone (302) 672-5650

Other identifiers 1

IdentifierTypeStateIssuer
419944800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20200221002234 DE Practitioner - Cardiovascular Disease (Cardiology) 1658566963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Perelman School of Med at the University of Pennsylvania, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Nemours FoundationGroup PAC ID 9537072483, 249 clinicians

Practice addresses (Care Compare)

1600 Rockland Rd
Wilmington, DE 19803-3607
Phone (302) 651-4200

Hospital & facility affiliations

  • Nemours Children'S Hospital, Delaware Hospital, Wilmington, DE, CCN 083300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0013525DEMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Feb 1, 2020 Accepting new patients
The Nemours Foundation CurrentSince Feb 1, 2020 Accepting new patients
University of Maryland Pediatric Associates, PA Pediatrics Current Accepting new patients
University of Maryland Pediatric Associates, PA Pediatrics CurrentSince Sep 15, 2010 Accepting new patients
University of Maryland Pediatric Assoc PA CurrentSince Sep 15, 2010 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

201 Towne Centre Dr
Ste 500
Dover, DE 19904
Phone (302) 672-5650

1600 Rockland Rd
Wilmington, DE 19803

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

Interoperability endpoints

  • Direct secure messaging: cbakersmith80904@direct.nemours.org

Organizations & group practices 9

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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1508031121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-4200",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607",
            "telephone_number": "302-651-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Towne Centre Dr Ste 500",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "DE",
            "postal_code": "199044062",
            "country_code": "US",
            "telephone_number": "302-672-5650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKER-SMITH",
        "first_name": "CARISSA",
        "middle_name": "MARRIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D70988",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MD",
            "license": "D70988",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "DE",
            "license": "C1-0013525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419944800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.