NPIMap

Organization Active NPI

Dove Healthcare Services ,LLC

  • Rehabilitation Clinic/Center
  • Baltimore, MD
National Provider Identifier
1629779079
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
DOVE HEALTHCARE SERVICES ,LLC
Practice address
2101 Saint Paul St
1St Floor
Baltimore, MD 21218-5981
Phone
(646) 961-8010
NPI assigned
Mar 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Authorized official

Name
Athanas Wasira
Title
Coo
Phone
(646) 961-8010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

2101 Saint Paul St
1St Floor
Baltimore, MD 21218-5981

Mailing address

2101 Saint Paul St
1St Floor
Baltimore, MD 21218-5981

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260410001208 MD Part B Supplier - Clinic/Group Practice 0547735169 Receives reassigned benefits from 3 practitioners
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory
Tax ID family
Dove Healthcare Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1629779079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 SAINT PAUL ST",
            "address_2": "1ST FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 SAINT PAUL ST",
            "address_2": "1ST FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185981",
            "telephone_number": "646-961-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOVE HEALTHCARE SERVICES ,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "WASIRA",
        "authorized_official_first_name": "ATHANAS",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "646-961-8010"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 1, 2024; 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.