Individual provider Active NPI

Judith A Callen, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1689691032
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0002613 Issued in MD
Practice address
201 E University Pkwy
Suite 425
Baltimore, MD 21218-2829
Phone
(410) 554-6497
Fax
(410) 554-6764
NPI assigned
Jul 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0002613 MD Primary

Addresses

Primary practice location

201 E University Pkwy
Suite 425
Baltimore, MD 21218-2829

Mailing address

201 E University Pkwy
Suite 425
Baltimore, MD 21218-2829
Phone (410) 554-6497

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081020000626 MD Practitioner - Physician Assistant 0244398246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Frederick Health Hospital IncGroup PAC ID 0446149256, shared by 8 NPIs, 127 clinicians
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1194 Dutchmans Creek Dr
Brunswick, MD 21716-9786
Phone (240) 215-6310

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440

2118 Greenspring Dr
Timonium, MD 21093-3112
Phone (410) 560-3480

3333 N Calvert St
Baltimore, MD 21218-6502

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0002613MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group Anesthesiology LLC CurrentSince Nov 1, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Greater Chesapeake Orthopedics Associates, LLC Past Accepting new patients
Union Memorial Hospital Past Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

201 E University Pkwy
Ste 425
Baltimore, MD 21218
Phone (410) 554-6497

2118 Greenspring Dr
Ste 110
Timonium, MD 21093

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1689691032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E UNIVERSITY PKWY",
            "address_2": "SUITE 425",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182829",
            "telephone_number": "410-554-6497",
            "fax_number": "410-554-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E UNIVERSITY PKWY",
            "address_2": "SUITE 425",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182829",
            "telephone_number": "410-554-6497",
            "fax_number": "410-554-6764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLEN",
        "first_name": "JUDITH",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.