Active NPI
Michelle Renee Pasternack, CCSW C
- Psychiatry Physician
- Columbia, MD
National Provider Identifier
1649217993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 04851
- Practice address
- 7130 Minstrel Way
Suite 212
Columbia, MD 21045 - Phone
- (410) 290-6940
- Fax
- (410) 290-9763
- NPI assigned
- Jun 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 04851 | MD | Primary |
Addresses
Primary practice location
7130 Minstrel Way
Suite 212
Columbia, MD 21045
Mailing address
120 Sister Pierre Drive
Suite 403
Towson, MD 21204
Phone (410) 823-6408
Other identifiers 17
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 150N | Other | MBMD GROUP | |
| 52317109 | Other | BSMD INDIVIDUAL | |
| PVPB119420 | Other | APS INDIVIDUAL | |
| 002668 | Other | VAL INDIVIDUAL | |
| 253552 | Other | COMP INDIVIDUAL | |
| 360218 | Other | MHN GROUP | |
| 705BPS | Other | BSMD GROUP | |
| K452 | Other | BSDC GROUP | |
| 226570 | Other | KAIS INDIVIDUAL | |
| 150N124G | Other | MBMD INDIVIDUAL | |
| 226570 | Other | KAIS GROUP | |
| 002668 | Other | VAL GROUP | |
| 2139989 | Other | MAMS INDIVIDUAL | |
| 0016 | Other | BSDC INDIVIDUAL | |
| 252450 | Other | COMP GROUP | |
| 331947 | Other | MHN INDIVIDUAL | |
| PVPB119420 | Other | APS GROUP |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04851 | MD | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psych Associates of Maryland LLC | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649217993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 SISTER PIERRE DRIVE",
"address_2": "SUITE 403",
"city": "TOWSON",
"state": "MD",
"postal_code": "21204",
"telephone_number": "410-823-6408",
"fax_number": "443-279-0537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7130 MINSTREL WAY",
"address_2": "SUITE 212",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "21045",
"telephone_number": "410-290-6940",
"fax_number": "410-290-9763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASTERNACK",
"first_name": "MICHELLE",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "CCSW C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "04851",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MBMD GROUP",
"identifier": "150N",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSMD INDIVIDUAL",
"identifier": "52317109",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APS INDIVIDUAL",
"identifier": "PVPB119420",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VAL INDIVIDUAL",
"identifier": "002668",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMP INDIVIDUAL",
"identifier": "253552",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN GROUP",
"identifier": "360218",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSMD GROUP",
"identifier": "705BPS",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSDC GROUP",
"identifier": "K452",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAIS INDIVIDUAL",
"identifier": "226570",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MBMD INDIVIDUAL",
"identifier": "150N124G",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAIS GROUP",
"identifier": "226570",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VAL GROUP",
"identifier": "002668",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMS INDIVIDUAL",
"identifier": "2139989",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSDC INDIVIDUAL",
"identifier": "0016",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMP GROUP",
"identifier": "252450",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN INDIVIDUAL",
"identifier": "331947",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APS GROUP",
"identifier": "PVPB119420",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.