Individual provider Active NPI

Patricia Tom, M.D.

  • Family Medicine Physician
  • Timonium, MD
National Provider Identifier
1760777692
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0037898 Issued in MD
Practice address
16 Greenmeadow Dr
Suite G105
Timonium, MD 21093-3200
Phone
(410) 561-5773
NPI assigned
Jun 20, 2011
Last updated
Feb 22, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0037898 MD Primary

Addresses

Primary practice location

16 Greenmeadow Dr
Suite G105
Timonium, MD 21093-3200

Mailing address

1829 Reisterstown Rd
Suite 205
Baltimore, MD 21208-6320
Phone (410) 602-9850

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110712000669 MD Practitioner - Family Practice 3678741907 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Lifebridge Community Physicians Inc CurrentSince Jan 1, 2014 Accepting new patients
Lifebridge Community Physicians, Inc CurrentSince Jan 1, 2014 Accepting new patients

Locations

118 Shawan Rd
Ste 220
Hunt Valley, MD 21030
Phone (410) 469-4950

9649 Belair Rd
Fl 2
Nottingham, MD 21236
Phone (410) 256-9340

1829 Reisterstown Rd
Ste 205
Pikesville, MD 21208
Phone (410) 602-9850

16 Greenmeadow Dr
Ste G105
Timonium, MD 21093
Phone (410) 561-5773

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329868800000",
    "number": "1760777692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 REISTERSTOWN RD",
            "address_2": "SUITE 205",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212086320",
            "telephone_number": "410-602-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 GREENMEADOW DR",
            "address_2": "SUITE G105",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210933200",
            "telephone_number": "410-561-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOM",
        "first_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2012-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0037898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Timonium, MD

Sources for this page

Verify at the official NPI Registry.