Individual provider Active NPI

Elizabeth Chacko, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Baltimore, MD
National Provider Identifier
1528337391
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
H86512 Issued in MD
Practice address
7106 Ridge Rd Ste B
Baltimore, MD 21237-3883
Phone
(443) 777-6351
Fax
(877) 423-2285
NPI assigned
Dec 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0166029051 VA
Student in an Organized Health Care Education/Training Program 390200000X 0166029051 VA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X H86512 MD Primary

Addresses

Primary practice location

7106 Ridge Rd Ste B
Baltimore, MD 21237-3883

Mailing address

7106 Ridge Rd Ste B
Baltimore, MD 21237-3883
Phone (443) 777-6351

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
I20190307003163 MD Practitioner - EndocrinologyPractitioner - Internal Medicine 2668790775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

7106 Ridge Rd
Suite B
Baltimore, MD 21237-3883
Phone (443) 777-6351

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0166029051VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC Internal Medicine CurrentSince Feb 1, 2019 Accepting new patients
Medstar Medical Group II LLC CurrentSince Feb 1, 2019 Accepting new patients

Locations

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

7106 Ridge Rd
Ste B
Rosedale, MD 21237
Phone (410) 687-2300

Organizations & group practices 2

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 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": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1528337391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7106 RIDGE RD STE B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373883",
            "telephone_number": "443-777-6351",
            "fax_number": "877-423-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7106 RIDGE RD STE B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373883",
            "telephone_number": "443-777-6351",
            "fax_number": "877-423-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-22",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0166029051",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0166029051",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MD",
            "license": "H86512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.