Individual provider Active NPI

Jonathan Urbina

  • Anesthesiology Physician
  • Baltimore, MD
National Provider Identifier
1538690672
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
D90667 Issued in MD
Practice address
600 N Wolfe St
Baltimore, MD 21287-0005
Phone
(410) 955-5000
NPI assigned
Mar 21, 2017
Last updated
Mar 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X D90667 MD Primary

Addresses

Primary practice location

600 N Wolfe St
Baltimore, MD 21287-0005

Mailing address

6201 Greenleigh Ave FL 2
Middle River, MD 21220-2004
Phone (410) 933-6421

Other practice location 1

20900 Biscayne Blvd
Aventura, FL 33180-1407
Phone (305) 682-7000

Other identifiers 1

IdentifierTypeStateIssuer
D90667OtherMDLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20220323001669 GA Practitioner - Anesthesiology 1254689193 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians
Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians

Practice addresses (Care Compare)

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068
Phone (770) 732-4022

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 702-1806

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jul 1, 2022 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Georgia Anesthesiologists, PC Anesthesiology CurrentSince Apr 1, 2022 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

531 Roselane St NW
Ste 830
Marietta, GA 30060
Phone (770) 658-9739

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500

Organizations & group practices 4

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 2

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": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1538690672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE FL 2",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20900 Biscayne Blvd",
            "address_purpose": "LOCATION",
            "city": "Aventura",
            "state": "FL",
            "postal_code": "331801407",
            "country_code": "US",
            "telephone_number": "305-682-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "URBINA",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D90667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "D90667",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.