Individual provider Active NPI

Minna Leydorf Rodrigo, MD

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1598260564
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0091300 Issued in MD
Practice address
22 S Greene St # S6Abc
Baltimore, MD 21201-1544
Phone
(410) 706-5181
Fax
(410) 225-9405
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X D91300 MD
Pediatrics Physician 208000000X D0091300 MD Primary

Addresses

Primary practice location

22 S Greene St # S6Abc
Baltimore, MD 21201-1544

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-6423

Other names 1

  • Minna Louise Leydorf Former name

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
I20230123000510 MD Practitioner - Pediatric Medicine 2668711318 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0091300MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Pediatric Associates, PA Pediatrics Current Accepting new patients
Johns Hopkins University CurrentSince Jan 5, 2023 Accepting new patients
Johns Hopkins University CurrentSince Jan 5, 2023 Accepting new patients
University of Maryland Pediatric Associates, PA Pediatrics CurrentSince Aug 5, 2024 Accepting new patients
Johns Hopkins University Current Accepting new patients
University of Maryland Pediatric Assoc PA CurrentSince Aug 5, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

22 S Greene St
#N5W70
Baltimore, MD 21201
Phone (410) 328-5213

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

22 S Greene St
#S6
Baltimore, MD 21201
Phone (667) 214-1916

601 N Caroline St
Baltimore, MD 21287
Phone (410) 955-5080

600 N Wolfe St
Baltimore, MD 21287

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

7556 Teague Rd
Ste 420
Hanover, MD 21076
Phone (410) 328-6749

1302 Bellona Ave
Lutherville Timonium, MD 21093
Phone (410) 825-6810

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: mlaydorf452406@direct.umm.edu

Organizations & group practices 7

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1598260564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-6423",
            "fax_number": "410-500-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST # S6ABC",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-706-5181",
            "fax_number": "410-225-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGO",
        "first_name": "MINNA",
        "middle_name": "LEYDORF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": "D91300",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0091300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINNA",
            "last_name": "LEYDORF",
            "middle_name": "LOUISE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.