Active NPI
Larry A Waskow, PA-C
- Physician Assistant
- Baltimore, MD
National Provider Identifier
1710949003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C0000274
- Practice address
- 1838 Greene Tree Rd
Suite 460
Baltimore, MD 21208-6391 - Phone
- (410) 581-1600
- NPI assigned
- Apr 4, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0000274 | MD | Primary |
Addresses
Primary practice location
1838 Greene Tree Rd
Suite 460
Baltimore, MD 21208-6391
Mailing address
25 Crossroads Dr
Suite 306
Owings Mills, MD 21117-5421
Phone (410) 581-1600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 970005850 | Other | MD | R/R MEDICARE PROVIDER # |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chesapeake Urology Associates LLC | Current | Accepting new patients | |
| Chesapeake Urology Associates, LLC | Past | Accepting new patients |
Locations
25 Crossroads Dr
Ste 306
Owings Mills, MD 21117
Phone (443) 231-1681
1838 Greene Tree Rd
Ste 460
Pikesville, MD 21208
Phone (410) 581-8140
Organizations & group practices 3
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.
-
- Hematology & Oncology Physician
- Stevensville, MD
- NPI 1467337337
-
- Urology Physician
- Owings Mills, MD
- NPI 1609823004
-
- Urology Physician
- Seaford, DE
- NPI 1043719123
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399334400000",
"number": "1710949003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 CROSSROADS DR",
"address_2": "SUITE 306",
"city": "OWINGS MILLS",
"state": "MD",
"postal_code": "211175421",
"telephone_number": "410-581-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1838 GREENE TREE RD",
"address_2": "SUITE 460",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212086391",
"telephone_number": "410-581-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASKOW",
"first_name": "LARRY",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-04",
"last_updated": "2014-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C0000274",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "R/R MEDICARE PROVIDER #",
"identifier": "970005850",
"state": "MD"
}
],
"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 May 6, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.