Individual provider Active NPI

Benjamin Baltazar Bandong, MD

  • Family Medicine Physician
  • Baltimore, MD
National Provider Identifier
1598732851
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0016938 Issued in MD
Practice address
1501 Division Street
Baltimore, MD 21217
Phone
(410) 383-8300
Fax
(410) 728-4412
NPI assigned
Mar 7, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0016938 MD Primary

Addresses

Primary practice location

1501 Division Street
Baltimore, MD 21217

Mailing address

308 Patleigh Road
Catonsville, MD 21228-5630
Phone (410) 788-8875

Other identifiers 2

IdentifierTypeStateIssuer
AB6155825OtherBHDD
D0016938OtherMDLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0016938MDMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1598732851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 PATLEIGH ROAD",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212285630",
            "telephone_number": "410-788-8875",
            "fax_number": "410-747-4237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 DIVISION STREET",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21217",
            "telephone_number": "410-383-8300",
            "fax_number": "410-728-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDONG",
        "first_name": "BENJAMIN",
        "middle_name": "BALTAZAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0016938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BHDD",
            "identifier": "AB6155825",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "D0016938",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.