NPIMap

Organization Active NPI

Baltimore Washington Professional Services Inc.

  • Surgery Physician
  • Glen Burnie, MD
National Provider Identifier
1710071725
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BALTIMORE WASHINGTON PROFESSIONAL SERVICES INC.
Practice address
203 Hospital Dr
Suite B100
Glen Burnie, MD 21061-6904
Phone
(410) 553-8351
Fax
(410) 553-8352
NPI assigned
Oct 3, 2006
Organization subpart
Yes
Parent organization
BALTIMORE WASHINGTON MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2009

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

Authorized official

Name
Charlene Ann Mayo
Title
Practice Manager
Phone
(410) 553-8353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

203 Hospital Dr
Suite B100
Glen Burnie, MD 21061-6904

Mailing address

203 Hospital Dr
Suite B100
Glen Burnie, MD 21061-6904
Phone (410) 553-8351

Other identifiers 12

IdentifierTypeStateIssuer
1622878OtherMDUNITED HEALTHCARE PROVIDE
2131125OtherMDMAMSI PROVIDER NUMBER
3767375OtherMDAETNA HMO PROVIDER NUMBER
406923400MedicaidMD
33525OtherMDJOHN HOPKINS HEALTH CARE
1303080OtherMDCIGNA PROVIDER NUMBER
704197OtherMDNCPPO PROVIDER NUMBER
DD8312OtherMDMEDICARE RAILROAD
J6860006OtherMHCAREFIRST BCBS OF DC PROV
5353197OtherMHAETNA PPO PROVIDER NUMBER
645177-01OtherMDCAREFIRST BCBS OF MD PROV
9002247OtherMDPRIVATE HEALTHCARE SYSTEM

Other names 1

  • THE AIELLO BREAST CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326001160 MD Part B Supplier - Clinic/Group Practice 7719879485 Receives reassigned benefits from 64 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glen Burnie, MD

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Part of
Baltimore Washington Medical Center

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257292800000",
    "number": "1710071725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 HOSPITAL DR",
            "address_2": "SUITE B100",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210616904",
            "telephone_number": "410-553-8351",
            "fax_number": "410-553-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 HOSPITAL DR",
            "address_2": "SUITE B100",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210616904",
            "telephone_number": "410-553-8351",
            "fax_number": "410-553-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALTIMORE WASHINGTON PROFESSIONAL SERVICES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BALTIMORE WASHINGTON  MEDICAL CENTER",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-11-04",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "410-553-8353"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PROVIDE",
            "identifier": "1622878",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI PROVIDER NUMBER",
            "identifier": "2131125",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO PROVIDER NUMBER",
            "identifier": "3767375",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406923400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN HOPKINS HEALTH CARE",
            "identifier": "33525",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "1303080",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO PROVIDER NUMBER",
            "identifier": "704197",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DD8312",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS OF DC PROV",
            "identifier": "J6860006",
            "state": "MH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO PROVIDER NUMBER",
            "identifier": "5353197",
            "state": "MH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS OF MD PROV",
            "identifier": "645177-01",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "9002247",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE AIELLO BREAST CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2009; 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.