NPIMap

Individual provider Active NPI

Mariaileen Sourwine, M.D.

  • Internal Medicine Physician
  • Arnold, MD
National Provider Identifier
1528227378
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D72591 Issued in MD
Practice address
277 Peninsula Farm Rd Ste I
Arnold, MD 21012-1018
Phone
(410) 989-8833
Fax
(410) 975-5641
NPI assigned
Jun 6, 2008
Last updated
Dec 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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 D72591 MD Primary

Addresses

Primary practice location

277 Peninsula Farm Rd Ste I
Arnold, MD 21012-1018

Mailing address

277 Peninsula Farm Rd Ste I
Arnold, MD 21012-1018
Phone (410) 989-8833

Other identifiers 1

IdentifierTypeStateIssuer
D72591OtherMDMARYLAND STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110921000397 MD Practitioner - Internal Medicine 8022289198 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Maryland School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Care Center LLCGroup PAC ID 3274801139, 286 clinicians

Practice addresses (Care Compare)

110 Baughmans LN
Suite 140
Frederick, MD 21702-4649
Phone (240) 215-1138

277 Peninsula Farm Rd
Suite I
Arnold, MD 21012-1018
Phone (410) 989-8833

301 Saint Paul St
Suite 409
Baltimore, MD 21202-2102
Phone (410) 659-7041

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Internal Medicine CurrentSince Jan 19, 2020 Accepting new patients
Menocal Medical Services PA Current Accepting new patients
Privia Care Center LLC Internal Medicine Current Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Inspireim, LLC Internal Medicine Current Accepting new patients
Privia Medical Group, LLC CurrentSince Jan 19, 2020 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Titus C. Abraham, MD, LLC Internal Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

277 Peninsula Farm Rd
Ste I
Arnold, MD 21012
Phone (410) 315-8253

301 Saint Paul St
Ste 409
Baltimore, MD 21202
Phone (410) 659-7041

110 Baughmans Ln
Ste 140
Frederick, MD 21702
Phone (240) 215-1138

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mariaileen.sourwine.1@8042.direct.athenahealth.com

Organizations & group practices 10

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.

Hospital & facility affiliations 7

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": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1528227378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 PENINSULA FARM RD STE I",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210121018",
            "telephone_number": "410-989-8833",
            "fax_number": "410-975-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 PENINSULA FARM RD STE I",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210121018",
            "telephone_number": "410-989-8833",
            "fax_number": "410-975-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOURWINE",
        "first_name": "MARIAILEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D72591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND STATE LICENSE",
            "identifier": "D72591",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arnold, MD

Sources for this page

Verify at the official NPI Registry.