NPIMap

Individual provider Active NPI

Blake Leibowitz, PA-C

  • Physician Assistant
  • Rockville, MD
National Provider Identifier
1578012118
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
14995 Shady Grove Rd
Rockville, MD 20850-8726
Phone
(301) 942-7600
Fax
(301) 217-9241
NPI assigned
Sep 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

14995 Shady Grove Rd
Rockville, MD 20850-8726

Mailing address

2730 University Blvd W Ste 310
Wheaton, MD 20902-1990
Phone (301) 942-7600

Other practice location 1

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 521-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161213002281 MD Practitioner - Physician Assistant 3577843341 Reassigns benefits to 6 organizations
I20220407000536 DC Practitioner - Physician Assistant 3577843341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spine and Joint Institute LLCGroup PAC ID 6608282231, 3 clinicians
Medstar Urgent Care LLCGroup PAC ID 9335303155, 300 clinicians

Practice addresses (Care Compare)

325 Hospital Dr
Suite 108
Glen Burnie, MD 21061-5806
Phone (240) 678-7309

6317 York Rd
Baltimore, MD 21212-2310
Phone (443) 777-6890

7226 Lee Deforest Dr
Suite 102
Columbia, MD 21046-3239
Phone (410) 753-4244

8605 Ridgelys Choice Dr
Nottingham, MD 21236-2953
Phone (410) 248-2310

Merit-based Incentive Payment System (MIPS)

Final score
85.72 of 100Reported as group
Quality
93.41
Promoting interoperability
100
Improvement activities
40
Cost
59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Urgent Care LLC CurrentSince Jul 30, 2023 Accepting new patients
Cep America LLC CurrentSince Jan 14, 2020 Accepting new patients
Cep America LLC CurrentSince Jan 14, 2020 Accepting new patients
Spine and Joint Institute LLC CurrentSince Jan 1, 2026 Accepting new patients
Medstar Urgent Care, LLC CurrentSince Jul 30, 2023 Accepting new patients
Medstar Urgent Care LLC CurrentSince Jul 30, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

325 Hospital Dr
Ste 108
Glen Burnie, MD 21061
Phone (240) 678-7309

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

Interoperability endpoints

  • Direct secure messaging: blake.leibowitz.p1@direct.aramd.nextgenshare.com

Organizations & group practices 11

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": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1578012118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 UNIVERSITY BLVD W STE 310",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209021990",
            "telephone_number": "301-942-7600",
            "fax_number": "301-942-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14995 SHADY GROVE RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208508726",
            "telephone_number": "301-942-7600",
            "fax_number": "301-217-9241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5401 Old Court Rd",
            "address_purpose": "LOCATION",
            "city": "Randallstown",
            "state": "MD",
            "postal_code": "211335103",
            "country_code": "US",
            "telephone_number": "410-521-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIBOWITZ",
        "first_name": "BLAKE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.