NPIMap

Organization Active NPI

Greater Baltimore Medical Center, Inc.

  • Surgery Physician
  • Baltimore, MD
National Provider Identifier
1619905460
Registry record updated May 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
GREATER BALTIMORE MEDICAL CENTER, INC.
Practice address
6701 N Charles St
Baltimore, MD 21204-6808
Phone
(443) 849-3082
NPI assigned
Jun 29, 2006
Organization subpart
Yes
Parent organization
GREATER BALTIMORE MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 12, 2010

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

Authorized official

Name
Mr. Eric Melchior
Title
Executive Vice Pres & Cfo
Phone
(443) 849-2519

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X

Addresses

Primary practice location

6701 N Charles St
Baltimore, MD 21204-6808

Mailing address

PO Box 631568
Baltimore, MD 21263-1568
Phone (443) 204-8188

Other identifiers 6

IdentifierTypeStateIssuer
K570OtherMDCAREFIRST REGIONAL
S127OtherMDCAREFIRST REGIONAL
KJ73GBOtherMDCAREFIRST MARYLAND
S130OtherMDCAREFIRST REGIONAL
878BGROtherMDCAREFIRST MARYLAND
512600200MedicaidMD

Other names 1

  • Greater Baltimore Multi-Surgical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000852 MD Part B Supplier - Clinic/Group Practice 1759276975 Receives reassigned benefits from 513 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
GB Head and Neck Assoc80 organizations share this tax ID, including this one
Part of
GB Head and Neck Assoc

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273622400000",
    "number": "1619905460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631568",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212631568",
            "telephone_number": "443-204-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046808",
            "telephone_number": "443-849-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER BALTIMORE MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREATER BALTIMORE MEDICAL CENTER, INC.",
        "enumeration_date": "2006-06-29",
        "last_updated": "2010-05-12",
        "status": "A",
        "authorized_official_last_name": "MELCHIOR",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRES & CFO",
        "authorized_official_telephone_number": "443-849-2519",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST REGIONAL",
            "identifier": "K570",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST REGIONAL",
            "identifier": "S127",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MARYLAND",
            "identifier": "KJ73GB",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST REGIONAL",
            "identifier": "S130",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MARYLAND",
            "identifier": "878BGR",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "512600200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Baltimore Multi-Surgical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.