NPIMap

Individual provider Active NPI

Deepak Baskaran, M.D.

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1730135278
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0062757 Issued in MD
Practice address
3455 Wilkens Ave
LL10
Baltimore, MD 21229-5213
Phone
(410) 644-4444
Fax
(410) 644-4484
NPI assigned
May 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0062757 MD Primary

Addresses

Primary practice location

3455 Wilkens Ave
LL10
Baltimore, MD 21229-5213

Mailing address

100 Harborview Dr
#908
Baltimore, MD 21230-5415
Phone (443) 838-5867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081010000526 MD Practitioner - Internal Medicine 9638247133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sambandam Baskaran M.D.,P.a.Group PAC ID 9537210323, 4 clinicians

Practice addresses (Care Compare)

3455 Wilkens Ave
Suite LL10
Baltimore, MD 21229-5294
Phone (410) 644-4444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0062757MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sambandam Baskaran M.D.,P.a. Internal Medicine CurrentSince Apr 12, 2009 Accepting new patients
1502 Frederick Road Opco LLC PastSince Jun 1, 2022 Accepting new patients
St. Agnes Healthcare, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3455 Wilkens Ave
Ste L10
Baltimore, MD 21229

3455 Wilkens Ave
Ste LL10
Baltimore, MD 21229
Phone (410) 644-4444

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Meadow Park Rehabilitation and Healthcare CenterCatonsville, MD, CCN 215347 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 2018
Jul 1, 2018
6116 Belair Road Opco LLCBaltimore, MD, CCN 215209 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2022
Jun 1, 2022
Autumn Lake Healthcare at Summit ParkCatonsville, MD, CCN 215326 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2022
Jun 1, 2022

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730135278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HARBORVIEW DR",
            "address_2": "#908",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212305415",
            "telephone_number": "443-838-5867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 WILKENS AVE",
            "address_2": "LL10",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295213",
            "telephone_number": "410-644-4444",
            "fax_number": "410-644-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASKARAN",
        "first_name": "DEEPAK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0062757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.