NPIMap

Organization Active NPI

St Paul Place Specialists, Inc.

  • Cardiovascular Disease Physician
  • Baltimore, MD
National Provider Identifier
1780630004
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
ST PAUL PLACE SPECIALISTS, INC.
Practice address
301 St. Paul Place
Heart Center - Burk BLDG 310
Baltimore, MD 21202-2102
Phone
(410) 332-9752
Fax
(410) 332-0626
NPI assigned
May 26, 2006
Last updated
Dec 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Authorized official

Name
Justin Deibel
Title
Executive Vice President & Cfo
Phone
(410) 659-2905

Specialties & licenses 2

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

Addresses

Primary practice location

301 St. Paul Place
Heart Center - Burk BLDG 310
Baltimore, MD 21202-2102

Mailing address

PO Box 824173
Philadelphia, MD 19182-4173

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031202000084 MD Part B Supplier - Clinic/Group Practice 7719882943 Receives reassigned benefits from 568 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Towson, MD; Baltimore, MD; Randallstown, MD; Pikesville, MD; Lutherville Timonium, MD; Lutherville, MD; Laurel, MD; Glen Burnie, MD…

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory

Locations

301 Saint Paul St
#310
Baltimore, MD 21202

301 Saint Paul St
Ste 310
Baltimore, MD 21202
Phone (410) 332-9717

301 Saint Paul St
Ste 711
Baltimore, MD 21202

5450 Knoll North Dr
Ste 180
Columbia, MD 21045
Phone (410) 730-7040

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1780630004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 824173",
            "city": "PHILADELPHIA",
            "state": "MD",
            "postal_code": "191824173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ST. PAUL PLACE",
            "address_2": "HEART CENTER - BURK BLDG 310",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102",
            "telephone_number": "410-332-9752",
            "fax_number": "410-332-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST PAUL PLACE SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "DEIBEL",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "410-659-2905"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 18, 2024; 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.