Caroline H Poblete, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

D45386 Issued in MD

Practice address

3454 Ellicott Center Dr
Suite 106
Ellicott City, MD 21043-4113

Phone

(410) 461-3760

Fax

(410) 461-0526

NPI assigned

Sep 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• University of Maryland Psychiatry Associates, PA

  dba Psychiatry Associates, PA

  • Psychiatry Physician
  • Baltimore, MD
  • NPI 1649292699
  NPD (past)

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1750485025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3454 ELLICOTT CENTER DR",
            "address_2": "SUITE 106",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210434113",
            "telephone_number": "410-461-3760",
            "fax_number": "410-461-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3454 ELLICOTT CENTER DR",
            "address_2": "SUITE 106",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210434113",
            "telephone_number": "410-461-3760",
            "fax_number": "410-461-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POBLETE",
        "first_name": "CAROLINE",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-08",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D45386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "596105000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frederick Charles Pitz Jr., CMT
• Pivot Physical Therapy of Central Maryland LLC
• Pivot Physical Therapy of Central Maryland LLC
• Plastic Surgery, P.a. (Plastic Surgery Professionals)
• Susan Pleva, D.D.S.
• Dwight A Polk, LCSW-C
• Kelly Pool, MA, CCC-SLP
• Melisa Lee Pool, LCSW-C
• Brenae Catherine Pope
• Dominique Pope, PMHNP

• Child & Adolescent Psychiatry Physician in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Child & Adolescent Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.

Verify at the official NPI Registry.