Organization Active NPI

Eric L. Weisbrot, M.D., P.a.

  • Primary Care Clinic/Center
  • Baltimore, MD
National Provider Identifier
1790812808
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
D0021487 Issued in MD
Legal business name
ERIC L. WEISBROT, M.D., P.A.
Practice address
1021 N Calvert St
Baltimore, MD 21202-3823
Phone
(410) 637-8255
Fax
(410) 637-8277
NPI assigned
Feb 27, 2007
Last updated
Dec 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

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

Authorized official

Name
Dr. Eric L. Weisbrot, M.D.NPI 1285626044
Title
President
Phone
(410) 637-8255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X D0021487 MD Primary

Addresses

Primary practice location

1021 N Calvert St
Baltimore, MD 21202-3823

Mailing address

1021 N Calvert St
Baltimore, MD 21202-3823
Phone (410) 637-8255

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101216000575 MD Part B Supplier - Clinic/Group Practice 4082802145 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228694400000",
    "number": "1790812808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N CALVERT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212023823",
            "telephone_number": "410-637-8255",
            "fax_number": "410-637-8277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 N CALVERT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212023823",
            "telephone_number": "410-637-8255",
            "fax_number": "410-637-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC L. WEISBROT, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2008-12-08",
        "status": "A",
        "authorized_official_last_name": "WEISBROT",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-637-8255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MD",
            "license": "D0021487",
            "primary": true
        }
    ],
    "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 8, 2008; 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.