Individual provider Active NPI

Patrick G Huckenpoehler, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1639896319
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0008646 Issued in MD
Practice address
345 Saint Paul St
Baltimore, MD 21202-2123
Phone
(410) 332-9000
NPI assigned
Oct 24, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0008646 MD Primary

Addresses

Primary practice location

345 Saint Paul St
Baltimore, MD 21202-2123

Mailing address

345 Saint Paul St
Baltimore, MD 21202-2123
Phone (410) 332-9000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230130002727 MD Practitioner - Physician Assistant 9931570900 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Paul Place Specialists, Inc.Group PAC ID 7719882943, 332 clinicians

Practice addresses (Care Compare)

301 Saint Paul St
Baltimore, MD 21202-2102

7602 Belair Rd
Baltimore, MD 21236-4088
Phone (410) 663-8100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.13 of 100Reported as group
Quality
56.5
Promoting interoperability
100
Improvement activities
40
Cost
73.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0008646MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Paul Place Specialists, Inc. CurrentSince Dec 15, 2022 Accepting new patients
St Paul Place Specialists Inc CurrentSince Dec 15, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

345 Saint Paul St
Fl 4
Baltimore, MD 21202
Phone (410) 332-9036

345 Saint Paul St
Baltimore, MD 21202
Phone (410) 332-9594

301 Saint Paul St
Baltimore, MD 21202
Phone (410) 385-4930

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

Interoperability endpoints

  • Direct secure messaging: phuckenpoehler35905@direct.mdmercy.com

Organizations & group practices 6

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": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1639896319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022123",
            "telephone_number": "410-332-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022123",
            "telephone_number": "410-332-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUCKENPOEHLER",
        "first_name": "PATRICK",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.