NPIMap

Organization Active NPI

Greater Baltimore Medical Center, Inc.

  • Vascular Surgery Physician
  • Baltimore, MD
National Provider Identifier
1528096377
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
GREATER BALTIMORE MEDICAL CENTER, INC.
Practice address
6569 N Charles St
Ste 701
Baltimore, MD 21204-6831
Phone
(443) 849-3431
NPI assigned
Jun 29, 2006
Organization subpart
Yes
Parent organization
GREATER BALTIMORE MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Authorized official

Name
Mr. Eric Melchior
Title
Executive Vice Pres & Cfo
Phone
(443) 849-2519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

6569 N Charles St
Ste 701
Baltimore, MD 21204-6831

Mailing address

PO Box 631568
Baltimore, MD 21263-1568

Other identifiers 2

IdentifierTypeStateIssuer
KJ64GBOtherMDCAREFIRST MARYLAND
S130OtherMDCAREFIRST REGIONAL

Other names 1

  • GBMC, Inc.-Vascular Surgery Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000852 MD Part B Supplier - Clinic/Group Practice 1759276975 Receives reassigned benefits from 513 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
GB Head and Neck Assoc

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1528096377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631568",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212631568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6569 N CHARLES ST",
            "address_2": "STE 701",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046831",
            "telephone_number": "443-849-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER BALTIMORE MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREATER BALTIMORE MEDICAL CENTER, INC.",
        "enumeration_date": "2006-06-29",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "MELCHIOR",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRES & CFO",
        "authorized_official_telephone_number": "443-849-2519",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MARYLAND",
            "identifier": "KJ64GB",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST REGIONAL",
            "identifier": "S130",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GBMC, Inc.-Vascular Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.