Individual provider Active NPI

Colleen Mary Leavitt, MD

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1528042959
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0061825 Issued in MD
Practice address
1000 E Eager St
Baltimore, MD 21202
Phone
(410) 522-9800
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0061825 MD Primary

Addresses

Primary practice location

1000 E Eager St
Baltimore, MD 21202

Mailing address

9910 Franklin Square Dr # 2110
Baltimore, MD 21236-4902
Phone (410) 933-5412

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
I20050804000869 MD Practitioner - Internal MedicinePractitioner - Pediatric Medicine 8022098524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Johns Hopkins Community Physicians, IncGroup PAC ID 8325943707, 764 clinicians
Baltimore Medical System, Inc.Group PAC ID 5395653455, shared by 8 NPIs, 86 clinicians

Practice addresses (Care Compare)

1000 E Eager St
E Baltimore Med Ctr
Baltimore, MD 21202-5533
Phone (410) 522-9800

5525 Eastern Ave
Baltimore, MD 21224-2796
Phone (410) 558-4804

Hospital & facility affiliations

  • Johns Hopkins Hospital, the Hospital, Baltimore, MD, CCN 210009
  • Johns Hopkins Bayview Medical Center Hospital, Baltimore, MD, CCN 210029

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0061825MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians, Inc Internal Medicine CurrentSince Nov 3, 2014 Accepting new patients
Johns Hopkins Community Physicians Internal Medicine CurrentSince Nov 3, 2014 Accepting new patients
Peoples Community Health Center, Inc Past Accepting new patients
Peoples Community Health Center, Inc Past Accepting new patients

Locations

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

9910 Franklin Square Dr
#2110
Nottingham, MD 21236
Phone (410) 933-5412

Interoperability endpoints

  • Direct secure messaging: cleavitt193141@direct.hopkinsmedicine.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1528042959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 FRANKLIN SQUARE DR # 2110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364902",
            "telephone_number": "410-933-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E EAGER ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21202",
            "telephone_number": "410-522-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVITT",
        "first_name": "COLLEEN",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0061825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.