Individual provider Active NPI

Lauren Iana Rudin

  • Clinical Psychologist
  • Baltimore, MD
National Provider Identifier
1548856396
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
06520 Issued in MD
Practice address
3800 Frederick Ave
Baltimore, MD 21229-3618
Phone
(410) 233-1400
NPI assigned
Dec 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 06520 MD Primary

Addresses

Primary practice location

3800 Frederick Ave
Baltimore, MD 21229-3618

Mailing address

17 Barkley LN
Gaithersburg, MD 20877-6329

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ?

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231221000086 DC Practitioner - Clinical Psychologist 5991155699 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

110 Irving St NW
Washington, DC 20010-3017
Phone (202) 877-7000

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

State licenses

LicenseStateTypeSpecialty
06520MDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Hospital Center Corp Current Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2023 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2023 Accepting new patients
Washington Hospital Center Corp CurrentSince Oct 9, 2023 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

3007 Tilden St NW
Ste 5N
Washington, DC 20008

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1548856396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BARKLEY LN",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208776329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 FREDERICK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212293618",
            "telephone_number": "410-233-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDIN",
        "first_name": "LAUREN",
        "middle_name": "IANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "06520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "?",
            "affiliation": "N",
            "address_1": "3800 Frederick Ave",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212293618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.