Individual provider Active NPI

David L Shevitz, M.D.

  • Psychiatry Physician
  • Baltimore, MD
National Provider Identifier
1679512503
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0043692 Issued in MD
Practice address
3811 Canterbury Rd
Baltimore, MD 21218-2340
Phone
(443) 604-4383
Fax
(410) 889-3616
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D0043692 MD Primary

Addresses

Primary practice location

3811 Canterbury Rd
Baltimore, MD 21218-2340

Mailing address

3811 Tabor Rd
Owings Mills, MD 21117-1245
Phone (443) 604-4383

Other identifiers 3

IdentifierTypeStateIssuer
182441400MedicaidMD
260036595OtherMDR/R MEDICARE PROVIDER #
CC3779OtherMDR/R MEDICARE GROUP #

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928001012 MD Practitioner - Psychiatry 7618093550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Maryland School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3811 Canterbury Rd
Baltimore, MD 21218-2340
Phone (443) 604-4383

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0043692MDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shevitz Psychiatric Psychiatry CurrentSince Aug 15, 2022 Accepting new patients

Locations

3811 Canterbury Rd
Ste B1
Baltimore, MD 21218
Phone (443) 604-4383

3811 Canterbury Rd
Baltimore, MD 21218
Phone (410) 889-9404

3811 Canterbury Rd
Ofc
Baltimore, MD 21218
Phone (410) 889-9404

Interoperability endpoints

  • Direct secure messaging: dshevitz210063@direct.umm.edu

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1679512503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 TABOR RD",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211171245",
            "telephone_number": "443-604-4383",
            "fax_number": "410-889-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 CANTERBURY RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182340",
            "telephone_number": "443-604-4383",
            "fax_number": "410-889-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEVITZ",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0043692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182441400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE PROVIDER #",
            "identifier": "260036595",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE GROUP #",
            "identifier": "CC3779",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.