Individual provider Active NPI

Joseph Michael Slattery, M.D.

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1528591062
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D88941 Issued in MD
Practice address
22 S Greene St
Room N5W70
Baltimore, MD 21201-1544
Phone
(410) 328-6662
NPI assigned
Apr 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D88941 MD Primary

Addresses

Primary practice location

22 S Greene St
Room N5W70
Baltimore, MD 21201-1544

Mailing address

22 S Greene St
Room N5W70
Baltimore, MD 21201-1544

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
I20200505002920 MD Practitioner - Pediatric MedicinePractitioner - Hospitalist 6507131307 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D88941MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Jul 1, 2023 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Jul 1, 2023 Accepting new patients
University of Maryland Pediatric Associates, PA Pediatrics Current Accepting new patients
University of Maryland Pediatrics Assoc PA CurrentSince May 30, 2020 Accepting new patients
University of Maryland Pediatric Associates, PA Pediatrics CurrentSince May 30, 2020 Accepting new patients
University of Maryland St. Joseph Medical Center, LLC Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

22 S Greene St
Rm N5W70
Baltimore, MD 21201
Phone (410) 328-0812

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1528591062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "address_2": "ROOM N5W70",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "address_2": "ROOM N5W70",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATTERY",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-11",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D88941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.