Individual provider Active NPI

Alexandra Shipman Rackoff

  • Emergency Medicine Physician
  • Baltimore, MD
National Provider Identifier
1750656195
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D0079393 Issued in MD
Practice address
110 S Paca St
6TH Floor, Suite 200
Baltimore, MD 21201-1642
Phone
(410) 328-8025
Fax
(410) 328-8028
NPI assigned
Mar 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D0079393 MD Primary

Addresses

Primary practice location

110 S Paca St
6TH Floor, Suite 200
Baltimore, MD 21201-1642

Mailing address

110 S Paca St
6TH Floor, Suite 200
Baltimore, MD 21201-1642
Phone (410) 328-8025

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20171207001671 WA Practitioner - Emergency Medicine 0143535377 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Maryland School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians
Eastside Emergency Physicians PLLCGroup PAC ID 5193725372, 56 clinicians

Practice addresses (Care Compare)

18100 NE Union Hill Rd
Suite 200
Redmond, WA 98052-3330
Phone (206) 320-5190

751 NE Blakely Dr
Issaquah, WA 98029-6201
Phone (425) 394-0610

Hospital & facility affiliations

  • Swedish Issaquah Hospital, Issaquah, WA, CCN 500152
  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0079393MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Current Accepting new patients
Eastside Emergency Physicians, PLLC Emergency Medicine CurrentSince Nov 14, 2017 Accepting new patients
Swedish Health Services CurrentSince Feb 2, 2020 Accepting new patients
Eastside Emergency Physicians PLLC Emergency Medicine Current Accepting new patients
Eastside Emergency Physicians, PLLC Emergency Medicine CurrentSince Nov 14, 2017 Accepting new patients
Swedish Health Services CurrentSince Feb 2, 2020 Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

751 NE Blakely Dr
Issaquah, WA 98029
Phone (425) 313-4000

18100 NE Union Hill Rd
Redmond, WA 98052
Phone (425) 498-2020

18100 NE Union Hill Rd
Ste 200
Redmond, WA 98052
Phone (206) 320-5190

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1750656195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S PACA ST",
            "address_2": "6TH FLOOR, SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011642",
            "telephone_number": "410-328-8025",
            "fax_number": "410-328-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S PACA ST",
            "address_2": "6TH FLOOR, SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011642",
            "telephone_number": "410-328-8025",
            "fax_number": "410-328-8028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACKOFF",
        "first_name": "ALEXANDRA",
        "middle_name": "SHIPMAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0079393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.