NPIMap

Organization Active NPI

University of Maryland Pediatric Associates, PA

  • Clinical Medical Laboratory
  • Baltimore, MD
National Provider Identifier
1679685804
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
UNIVERSITY OF MARYLAND PEDIATRIC ASSOCIATES, PA
Practice address
120 South Penn Street
Baltimore, MD 21201
Phone
(410) 706-5181
Fax
(410) 706-5103
NPI assigned
Sep 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Authorized official

Name
Margie Burr
Title
Director of Professional Fees
Phone
(410) 706-5181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

120 South Penn Street
Baltimore, MD 21201

Mailing address

P.O. Box 62063
Baltimore, MD 21264-2063
Phone (410) 706-5181

Other identifiers 1

IdentifierTypeStateIssuer
042118900MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040401000195 MD Part B Supplier - Clinic/Group Practice 6800888678 Receives reassigned benefits from 173 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lutherville, MD; Columbia, MD; Easton, MD; Frederick, MD; Glen Burnie, MD; Hanover, MD; La Plata, MD; Largo, MD…

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1679685804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 62063",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212642063",
            "telephone_number": "410-706-5181",
            "fax_number": "410-706-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SOUTH PENN STREET",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21201",
            "telephone_number": "410-706-5181",
            "fax_number": "410-706-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF MARYLAND PEDIATRIC ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "BURR",
        "authorized_official_first_name": "MARGIE",
        "authorized_official_title_or_position": "DIRECTOR OF PROFESSIONAL FEES",
        "authorized_official_telephone_number": "410-706-5181"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042118900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.