NPIMap

Organization Active NPI

Chesapeake Urology Associates, LLC

  • Urology Physician
  • Brandywine, MD
National Provider Identifier
1679398366
Registry record updated Mar 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
CHESAPEAKE UROLOGY ASSOCIATES, LLC
Practice address
7704 Matapeake Business Dr Ste 310
Brandywine, MD 20613-3046
Phone
(301) 868-0202
NPI assigned
Nov 19, 2024
Last updated
Mar 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2025

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

Authorized official

Name
Sanford Jay Siegel, MDNPI 1376506477
Title
President
Phone
(410) 581-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X Primary

Addresses

Primary practice location

7704 Matapeake Business Dr Ste 310
Brandywine, MD 20613-3046

Mailing address

10200 Grand Central Ave Ste 220
Owings Mills, MD 21117-4366
Phone (443) 471-5839

Other identifiers 1

IdentifierTypeStateIssuer
276600151MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111216000464 DC Part B Supplier - Clinic/Group Practice 4789673393 Receives reassigned benefits from 110 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Germantown, MD; Wheaton, MD; Silver Spring, MD; Rockville, MD; Potomac, MD; Oxon Hill, MD; Largo, MD; Gaithersburg, MD…

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D1027982Chesapeake Urology Associates7704 Matapeake Business Dr Suite 310, Brandywine, MD 20613Certificate of waiverFeb 29, 2028

National Provider Directory

National Provider Directory
Tax ID family
Chesapeake Urology40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

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

View all 39

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741392000000",
    "number": "1679398366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 GRAND CENTRAL AVE STE 220",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174366",
            "telephone_number": "443-471-5839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7704 MATAPEAKE BUSINESS DR STE 310",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133046",
            "telephone_number": "301-868-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE UROLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-19",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-08",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "SANFORD",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-581-1600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276600151",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandywine, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.