NPIMap

Individual provider Active NPI

Michael Kowalis, PA

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1790959369
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C03648 Issued in MD
Practice address
1830 E Monument Street RM 416
Baltimore, MD 21264-2149
Phone
(410) 955-5268
NPI assigned
Apr 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA030527 DC
Physician Assistant 363A00000X C03648 MD Primary

Addresses

Primary practice location

1830 E Monument Street RM 416
Baltimore, MD 21264-2149

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-6423

Other practice location 1

1150 Varnum St NE
Washington, DC 20017-2149
Phone (202) 269-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081007000627 MD Practitioner - Physician Assistant 5395816193 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Johns Hopkins University 2,886 clinicians

Practice addresses (Care Compare)

4940 Eastern Ave
Baltimore, MD 21224-2735
Phone (410) 550-0100

5601 Lloch Raven Blvd
Baltimore, MD 21239-2945
Phone (443) 444-4714

6201 Greenleigh Ave
Middle River, MD 21220-2004

Hospital & facility affiliations

  • Johns Hopkins Bayview Medical Center Hospital, Baltimore, MD, CCN 210029

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C03648MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore, Inc CurrentSince Oct 12, 2015 Accepting new patients
Johns Hopkins University CurrentSince Jul 24, 2023 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Oct 12, 2015 Accepting new patients
Johns Hopkins University CurrentSince Jul 24, 2023 Accepting new patients

Locations

5601 Loch Raven Blvd
#3N
Baltimore, MD 21239
Phone (410) 532-3775

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

2401 W Belvedere Ave
Baltimore, MD 21215

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: mkowalis1129774@direct.hopkinsmedicine.org

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 16

Hospital & facility affiliations 2

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": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1790959369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 E MONUMENT STREET RM 416",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212642149",
            "telephone_number": "410-955-5268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 Varnum St NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200172149",
            "country_code": "US",
            "telephone_number": "202-269-7000",
            "fax_number": "202-269-7825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOWALIS",
        "first_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA030527",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C03648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.