Individual provider Active NPI

Mark Andrew Chylinski, MD

  • Internal Medicine Physician
  • California, MD
National Provider Identifier
1710408539
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0091250 Issued in MD
Practice address
22590 Shady CT
California, MD 20619-5009
Phone
(301) 373-7900
Fax
(301) 373-6900
NPI assigned
Jul 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D91250 MD
Internal Medicine Physician 207R00000X D0091250 MD Primary

Addresses

Primary practice location

22590 Shady CT
California, MD 20619-5009

Mailing address

PO Box 640
Hollywood, MD 20636-0640
Phone (301) 373-7900

Other identifiers 1

IdentifierTypeStateIssuer
578017900MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210909000664 MD Practitioner - Internal Medicine 0941629026 Reassigns benefits to 1 organization
I20210909003640 DC Practitioner - Internal Medicine 0941629026 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D91250MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group - Southern Maryland LLC Current Accepting new patients
Symphony Medical Associates, PA CurrentSince Aug 1, 2021 Accepting new patients

Locations

821 N Eutaw St
Ste 308
Baltimore, MD 21201
Phone (410) 383-2072

9106 Pine View Ln
Clinton, MD 20735
Phone (301) 856-2930

24035 Three Notch Rd
Hollywood, MD 20636
Phone (301) 373-2588

1051 Brightseat Rd
Landover, MD 20785
Phone (240) 487-4400

Interoperability endpoints

  • Direct secure messaging: mark.chylinskimd.p2@direct.msmg.nextgenshare.com

Organizations & group practices 2

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": "1498867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1710408539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206360640",
            "telephone_number": "301-373-7900",
            "fax_number": "301-373-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22590 SHADY CT",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206195009",
            "telephone_number": "301-373-7900",
            "fax_number": "301-373-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHYLINSKI",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-01",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D91250",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0091250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "578017900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in California, MD

Sources for this page

Verify at the official NPI Registry.