Individual provider Active NPI

Theodore Leslie Deweese, M.D.

  • Radiation Oncology Physician
  • Baltimore, MD
National Provider Identifier
1528003373
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
D14152 Issued in MD
Practice address
600 N Wolfe St
Baltimore, MD 21287-0005
Phone
(410) 955-8964
NPI assigned
Jun 17, 2006
Last updated
Jan 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X D47485 MD
Radiation Oncology Physician 2085R0001X D14152 MD Primary

Addresses

Primary practice location

600 N Wolfe St
Baltimore, MD 21287-0005

Mailing address

PO Box 64474
Baltimore, MD 21264-4474
Phone (410) 614-3979

Other identifiers 1

IdentifierTypeStateIssuer
376561000MedicaidMD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100514000531 MD Practitioner - Radiation Oncology 1456489202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

600 N Wolf St
Baltimore, MD 21287-0005
Phone (410) 955-5000

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D14152MDMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Jan 1, 2012 Accepting new patients
Johns Hopkins University Radiation Oncology CurrentSince Jan 1, 2012 Accepting new patients
Johns Hopkins University Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
The Johns Hopkins Hospital PastSince Jul 1, 2013 Accepting new patients

Locations

600 N Wolfe St
Baltimore, MD 21287

5755 Cedar Ln
Columbia, MD 21044
Phone (410) 381-7171

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: tdeweese12473@direct.hopkinsmedicine.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Johns Hopkins HospitalBaltimore, MD, CCN 210009 Hospital Corporate Director Jul 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1528003373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64474",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644474",
            "telephone_number": "410-614-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-8964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWEESE",
        "first_name": "THEODORE",
        "middle_name": "LESLIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MD",
            "license": "D47485",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MD",
            "license": "D14152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376561000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.