NPIMap

Organization Active NPI

Lifebridge Community Physicians, Inc

  • Cardiovascular Disease Physician
  • Baltimore, MD
National Provider Identifier
1760864870
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
LIFEBRIDGE COMMUNITY PHYSICIANS, INC
Practice address
2700 Quarry Lake Dr Ste 160
Baltimore, MD 21209-3743
Phone
(410) 933-4923
Fax
(410) 933-8659
NPI assigned
Jun 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Authorized official

Name
Mary Wright-Sisk
Title
Director
Phone
(443) 422-9941

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X MD Primary
Interventional Cardiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RI0011X MD

Addresses

Primary practice location

2700 Quarry Lake Dr Ste 160
Baltimore, MD 21209-3743

Mailing address

2700 Quarry Lake Dr Ste 160
Baltimore, MD 21209-3743
Phone (410) 933-4923

Other practice location 1

8114 Sandpiper Cir
Suite 206
Nottingham, MD 21236-4934
Phone (410) 933-4923

Other names 1

  • LifeBridge Health Cardiology of Baltimore/Dr. Jerald Insel Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110627000318 MD Part B Supplier - Clinic/Group Practice 3678751468 Receives reassigned benefits from 358 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
DRS Gouel and Blotny148 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754438400000",
    "number": "1760864870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 QUARRY LAKE DR STE 160",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093743",
            "telephone_number": "410-933-4923",
            "fax_number": "410-933-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 QUARRY LAKE DR STE 160",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093743",
            "telephone_number": "410-933-4923",
            "fax_number": "410-933-8659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8114 Sandpiper Cir",
            "address_2": "Suite 206",
            "address_purpose": "LOCATION",
            "city": "Nottingham",
            "state": "MD",
            "postal_code": "212364934",
            "country_code": "US",
            "telephone_number": "410-933-4923",
            "fax_number": "410-933-8659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-25",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A",
        "authorized_official_last_name": "WRIGHT-SISK",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-422-9941"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MD",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeBridge Health Cardiology of Baltimore/Dr. Jerald Insel",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.