Individual provider Active NPI

Brian M Diller, PA-C

  • Surgical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1558746586
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C0005837 Issued in MD
Practice address
201 E University Pkwy
Baltimore, MD 21218-2829
Phone
(443) 690-5751
NPI assigned
Jul 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X C0005837 MD Primary

Addresses

Primary practice location

201 E University Pkwy
Baltimore, MD 21218-2829

Mailing address

201 E University Pkwy
Baltimore, MD 21218-2829
Phone (443) 690-5751

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151202001169 MD Practitioner - Physician Assistant 2163722844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians

Practice addresses (Care Compare)

12 Medstar Blvd
Bel Air, MD 21015-1798
Phone (410) 877-8088

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440

201 E University Pkwy
Baltimore, MD 21218-2829
Phone (410) 554-2000

2118 Greenspring Dr
Timonium, MD 21093-3112
Phone (410) 560-3480

3304 Guilford Ave
Baltimore, MD 21218-2829
Phone (410) 554-6740

Hospital & facility affiliations

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0005837MDMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Oct 30, 2015 Accepting new patients

Locations

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

Organizations & group practices 2

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 1

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": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1558746586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E UNIVERSITY PKWY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182829",
            "telephone_number": "443-690-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E UNIVERSITY PKWY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182829",
            "telephone_number": "443-690-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLER",
        "first_name": "BRIAN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-20",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0005837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.