Individual provider Active NPI

Danielle Marie Ploetz, PH.D.

  • Clinical Neuropsychologist
  • Baltimore, MD
National Provider Identifier
1669660999
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
05595 Issued in MD
Practice address
2931 E Biddle St
Baltimore, MD 21213-3939
Phone
(443) 923-1872
NPI assigned
Oct 11, 2007
Last updated
Sep 24, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Neuropsychologist 103G00000X 05595 MD Primary

Addresses

Primary practice location

2931 E Biddle St
Baltimore, MD 21213-3939

Mailing address

707 N Broadway
Baltimore, MD 21205-1832
Phone (443) 923-1872

Other identifiers 1

IdentifierTypeStateIssuer
00018214MedicaidMS

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
I20240416000348 MD Practitioner - Clinical Psychologist 3971942558 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Krieger Associates CurrentSince Mar 5, 2024 Accepting new patients
Kennedy Krieger Associates CurrentSince Mar 5, 2024 Accepting new patients

Locations

1741 Ashland Ave
Ste 642
Baltimore, MD 21205

2931 E Biddle St
Baltimore, MD 21213
Phone (443) 923-1872

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1669660999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051832",
            "telephone_number": "443-923-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2931 E BIDDLE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212133939",
            "telephone_number": "443-923-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOETZ",
        "first_name": "DANIELLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MD",
            "license": "05595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00018214",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.