Individual provider Active NPI

Ian Hoffman, M.D.

  • Pulmonary Disease Physician
  • Baltimore, MD
National Provider Identifier
1558494773
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
D0039845 Issued in MD
Practice address
1838 Greene Tree Rd
Suite 420
Baltimore, MD 21208-6391
Phone
(410) 484-9595
Fax
(410) 484-5139
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X D0039845 MD
Pulmonary Disease Physician 207RP1001X D0039845 MD Primary

Addresses

Primary practice location

1838 Greene Tree Rd
Suite 420
Baltimore, MD 21208-6391

Mailing address

400 Redland CT
Suite 208
Owings Mills, MD 21117-3290
Phone (410) 494-7921

Other identifiers 3

IdentifierTypeStateIssuer
52452203OtherBC BS MARYLAND
E5540032OtherBLUE CHOICE
P0075312OtherRR MEDICARE

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
I20040405001468 MD Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 6709879877 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0039845MDMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Physicians, Inc CurrentSince Oct 1, 2014 Accepting new patients
Lifebridge Community Physicians Inc CurrentSince Oct 1, 2014 Accepting new patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Lifebridge Community Physicians, Inc Critical Care Medicine Past Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

1838 Greene Tree Rd
Ste 420
Pikesville, MD 21208
Phone (410) 494-7920

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

515 Fairmount Ave
Towson, MD 21286
Phone (410) 296-5300

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

Organizations & group practices 5

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1558494773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 REDLAND CT",
            "address_2": "SUITE 208",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173290",
            "telephone_number": "410-494-7921",
            "fax_number": "410-902-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1838 GREENE TREE RD",
            "address_2": "SUITE 420",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212086391",
            "telephone_number": "410-484-9595",
            "fax_number": "410-484-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "IAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MD",
            "license": "D0039845",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MD",
            "license": "D0039845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS MARYLAND",
            "identifier": "52452203",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "E5540032",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P0075312",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.