NPIMap

Organization Active NPI

Harbor Hospital, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
National Provider Identifier
1720175623
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
HARBOR HOSPITAL, INC.
Practice address
3001 South Hanover St
Baltimore, MD 21225
Phone
(410) 350-3636
NPI assigned
Oct 10, 2006
Last updated
Apr 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Authorized official

Name
Mr. Govind Maheshwari
Title
Avp of Finance
Phone
(410) 350-3636

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MD
Psychiatric Hospital Unit 273R00000X
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

3001 South Hanover St
Baltimore, MD 21225

Mailing address

8020 Corporate Dr
Baltimore, MD 21236-4978

Other identifiers 1

IdentifierTypeStateIssuer
000145700MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081028000216 MD Part A Provider - Hospital 8022917079 Practice locations: Baltimore, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720175623. Details of each certification follow.

Hospital certification: CCN 210034

Legal name
HARBOR HOSPITAL, INC
Doing business as
MEDSTAR HARBOR HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Dec 19, 2017
Beds
376
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 3, 1903 in MD
Enrollment address
3001 S Hanover St
Baltimore, MD 21225-1233
Main/Primary Hospital Location
Hospital subgroups
Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Medstar Harbor HospitalCCN 210034 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Rifat K Abousy MD8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Dawn M Gretz Individual Corporate DirectorDirector Mar 18, 2013
Meredith Chaiken Individual Corporate Director Aug 16, 2022
Deana L Stout Individual Corporate OfficerTreasurer Apr 4, 2022
W-2 Managing EmployeeVP Finance and Cfo Apr 4, 2022
Thomas Geddes Individual Corporate DirectorDirector - Chairman Mar 1, 2016
Kenneth a Samet Individual Corporate Director Oct 9, 2012
Swata J Gandhi Individual Corporate Director May 9, 2018
Mohsen Gharib Individual Corporate Director Nov 3, 2020
Kathryn Hendricks Perry Individual W-2 Managing EmployeeDirector Financial Services Oct 26, 2020
Vincent F Connelly Individual Corporate DirectorDirector Oct 1, 2016
Kerunne Ketlogetswe Individual Corporate Director Nov 3, 2020
James Fields Individual Corporate DirectorDirector Oct 1, 2015
Carlos D Zigel Individual Corporate DirectorDirector Oct 1, 2016
Harbor Hospital, Inc Organization, Baltimore, MD Non-profit 5% Or Greater Direct Ownership Interest Feb 1, 1999 100%
Jill Donaldson Individual W-2 Managing EmployeePresident Mar 30, 2020
Maria Brisueno-Burnett Individual Other Nov 2, 1998
Medstar Health, Inc. Organization, Columbia, MD Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Feb 1, 1999 100%
Keith Shiner Individual Corporate OfficerSecretary Sep 8, 2017

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 13

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 13

Practitioners & affiliated clinicians

Practitioners 41

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 41

Affiliated clinicians 276

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 276

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1720175623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8020 CORPORATE DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 SOUTH HANOVER ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21225",
            "telephone_number": "410-350-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "MAHESHWARI",
        "authorized_official_first_name": "GOVIND",
        "authorized_official_title_or_position": "AVP OF FINANCE",
        "authorized_official_telephone_number": "410-350-3636",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000145700",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd Ste 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.