Individual provider Active NPI

Radcliffe Thomas

  • Nephrology Physician
  • Baltimore, MD
National Provider Identifier
1558337618
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
D42683 Issued in MD
Practice address
4000 W Northern Pkwy
Baltimore, MD 21215-4473
Phone
(410) 542-7700
NPI assigned
Feb 27, 2006
Last updated
Apr 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X D42683 MD Primary

Addresses

Primary practice location

4000 W Northern Pkwy
Baltimore, MD 21215-4473

Mailing address

7101 Carlisle CT
Clarksville, MD 21029-1739

Other identifiers 1

IdentifierTypeStateIssuer
204571100MedicaidMD

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
I20100215000277 MD Practitioner - NephrologyPractitioner - Internal Medicine 3779627781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Howard University College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4000 W Northern Pkwy
Baltimore, MD 21215-4473
Phone (410) 542-7700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D42683MDMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radcliffe M Thomas MD PA Nephrology CurrentSince Feb 26, 2010 Accepting new patients

Locations

4000 W Northern Pkwy
Baltimore, MD 21215
Phone (410) 466-0184

Organizations & group practices 1

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 5

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1558337618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 CARLISLE CT",
            "city": "CLARKSVILLE",
            "state": "MD",
            "postal_code": "210291739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W NORTHERN PKWY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212154473",
            "telephone_number": "410-542-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "RADCLIFFE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": "D42683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204571100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.