Individual provider Active NPI

Gino M Freeman, M.D.

  • Internal Medicine Physician
  • Towson, MD
National Provider Identifier
1770526105
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0063180 Issued in MD
Practice address
6701 N Charles St
Suite 4202
Towson, MD 21204-6808
Phone
(410) 400-2830
Fax
(410) 821-6237
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2015

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 D0063180 MD Primary

Addresses

Primary practice location

6701 N Charles St
Suite 4202
Towson, MD 21204-6808

Mailing address

6701 N Charles St
Suite 4202
Towson, MD 21204-6808
Phone (410) 400-2830

Other identifiers 1

IdentifierTypeStateIssuer
409128100MedicaidMD

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
I20050816000598 MD Practitioner - Internal Medicine 6103855234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

7600 Osler Dr
Suite 310
Towson, MD 21204-7702
Phone (410) 400-2830

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0063180MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
GMF Medical LLC Internal Medicine CurrentSince Jul 21, 2009 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

7600 Osler Dr
Ste 310
Towson, MD 21204
Phone (410) 296-2300

6701 N Charles St
Ste 4202
Towson, MD 21204
Phone (410) 400-2830

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.

Hospital & facility affiliations 4

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1770526105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 N CHARLES ST",
            "address_2": "SUITE 4202",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212046808",
            "telephone_number": "410-400-2830",
            "fax_number": "410-821-6237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 N CHARLES ST",
            "address_2": "SUITE 4202",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212046808",
            "telephone_number": "410-400-2830",
            "fax_number": "410-821-6237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "GINO",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0063180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "409128100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.