Individual provider Active NPI

S. Marc Testa, PH.D.

  • Clinical Neuropsychologist
  • Baltimore, MD
National Provider Identifier
1629114699
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
04253 Issued in MD
Practice address
5051 Greenspring Ave
Suite 200
Baltimore, MD 21209-4354
Phone
(443) 992-0762
Fax
(410) 601-7828
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 04253 MD Primary
Clinical Psychologist 103TC0700X 04253 MD

Addresses

Primary practice location

5051 Greenspring Ave
Suite 200
Baltimore, MD 21209-4354

Mailing address

5051 Greenspring Ave
Suite 200
Baltimore, MD 21209-4354
Phone (443) 992-0762

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070802000246 MD Practitioner - Clinical Psychologist 2769573997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Cincinnati College of Medicine, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Sinai Hospital of Baltimore, IncGroup PAC ID 0941112346, 373 clinicians

Practice addresses (Care Compare)

2700 Quarry Lake Dr
Baltimore, MD 21209-3743

2700 Quarry Lake Dr
Suite 180
Baltimore, MD 21209-1458

2700 Quarry Lake Dr
Suite 260
Baltimore, MD 21209-3744
Phone (410) 585-2830

5051 Greenspring Ave
Baltimore, MD 21209-4354
Phone (410) 601-9513

5051 Greenspring Ave
Baltimore, MD 21209-4358

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 521-5976

5401 Old Court Rd Breast Ctr
Randallstown, MD 21133-5185
Phone (410) 521-2200

5401 W Belvedere Ave
Sinai Oncology Associates
Randallstown, MD 21133
Phone (410) 521-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04253MDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince May 1, 2015 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince May 1, 2015 Accepting new patients

Locations

5051 Greenspring Ave
Ste 200
Baltimore, MD 21209
Phone (410) 367-7600

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

5051 Greenspring Ave
Baltimore, MD 21209
Phone (410) 601-1441

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1629114699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5051 GREENSPRING AVE",
            "address_2": "SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094354",
            "telephone_number": "443-992-0762",
            "fax_number": "410-601-7828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5051 GREENSPRING AVE",
            "address_2": "SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094354",
            "telephone_number": "443-992-0762",
            "fax_number": "410-601-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESTA",
        "first_name": "S. MARC",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MD",
            "license": "04253",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04253",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.