NPIMap

Organization Active NPI

Mosaic Community Services, Inc

Doing business as Sheppard Pratt

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Gaithersburg, MD
National Provider Identifier
1710466313
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MOSAIC COMMUNITY SERVICES, INC
Doing business as
Sheppard Pratt
Practice address
610 E Diamond Ave Ste 100
Gaithersburg, MD 20877-5321
Phone
(301) 840-3200
NPI assigned
Aug 14, 2018
Last updated
Jan 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Authorized official

Name
Sue Kessler
Title
Director, Revenue Cycle
Phone
(410) 382-8111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X MD Primary

Addresses

Primary practice location

610 E Diamond Ave Ste 100
Gaithersburg, MD 20877-5321

Mailing address

PO Box 45709
Baltimore, MD 21297-5709
Phone (410) 382-8111

Other names 1

  • Sheppard Pratt Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251008001370 DC Part B Supplier - Clinic/Group Practice 0941289417 Receives reassigned benefits from 3 practitioners
Practice locations: Gaithersburg, MD

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Mosaic Community Services Inc47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

Locations

5438 York Rd
Ste 201
Baltimore, MD 21212
Phone (410) 464-9504

604 Solarex Ct
Unit 100
Frederick, MD 21703
Phone (240) 200-4044

610 E Diamond Ave
Gaithersburg, MD 20877
Phone (301) 840-3200

Practitioners & affiliated clinicians

Practitioners 153

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 153

NPI Registry JSON

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1710466313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45709",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212975709",
            "telephone_number": "410-382-8111",
            "fax_number": "443-612-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E DIAMOND AVE STE 100",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208775321",
            "telephone_number": "301-840-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC COMMUNITY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-14",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "KESSLER",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "DIRECTOR, REVENUE CYCLE",
        "authorized_official_telephone_number": "410-382-8111"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sheppard Pratt",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.