Active NPI
Gwendolin Tifang
- Psychiatric/Mental Health Nurse Practitioner
- Baltimore, MD
National Provider Identifier
1700544707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- R226369
- Practice address
- 6501 N Charles St
Baltimore, MD 21204-6819 - Phone
- (410) 938-3000
- NPI assigned
- Dec 7, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R226369 | MD | Primary |
Addresses
Primary practice location
6501 N Charles St
Baltimore, MD 21204-6819
Mailing address
6501 N Charles St
Baltimore, MD 21204-6819
Phone (240) 915-5500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6501 N Charles St
Baltimore, MD 21204-6819
Phone (410) 938-5000
7220 Discovery Dr
Elkridge, MD 21075-7414
Phone (410) 938-3000
Merit-based Incentive Payment System (MIPS)
- Final score
- 66.41 of 100
- Quality
- 30.12
- Promoting interoperability
- 80
- Improvement activities
- 40
- Cost
- 57.93
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R226369 | MD | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sheppard Pratt Physicians, P.a. | Current | Accepting new patients |
Locations
6501 N Charles St
Towson, MD 21204
Phone (410) 938-3000
Organizations & group practices 5
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.
-
- Psychiatry Physician
- Baltimore, MD
- NPI 1518990712
-
- Psychiatric/Mental Health Nurse Practitioner
- Baltimore, MD
- NPI 1740049568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645488000000",
"number": "1700544707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6501 N CHARLES ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212046819",
"telephone_number": "240-915-5500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6501 N CHARLES ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212046819",
"telephone_number": "410-938-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIFANG",
"first_name": "GWENDOLIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-07",
"last_updated": "2022-02-22",
"certification_date": "2022-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MD",
"license": "R226369",
"primary": true
}
],
"identifiers": [],
"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 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.