NPIMap

Organization Active NPI

Baltimore Washington Professional Services Inc.

Doing business as BWMC Surgical Associates

  • Surgery Physician
  • Glen Burnie, MD
National Provider Identifier
1821277856
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BALTIMORE WASHINGTON PROFESSIONAL SERVICES INC.
Doing business as
BWMC Surgical Associates
Practice address
301 Hospital Dr
Glen Burnie, MD 21061-5803
Phone
(410) 787-4594
NPI assigned
Oct 26, 2007
Last updated
Jan 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Authorized official

Name
Amy Jo Noel
Title
Managed Care Coordinator
Phone
(410) 787-4594

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MD
Gynecology Physician 207VG0400X NU
Surgery Physician 208600000X NU Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU

Addresses

Primary practice location

301 Hospital Dr
Glen Burnie, MD 21061-5803

Mailing address

PO Box 64584
Baltimore, MD 21264-4584

Other identifiers 4

IdentifierTypeStateIssuer
ZEZTOtherMDMEDICARE GROUP
165767OtherMDMEDICARE PTAN
Q818OtherMDBLUE CROSS BLUE SHIELD
DB3GBWOtherMDBLUE CROSS BLUE SHIELD

Other names 1

  • BWMC SURGICAL ASSOCIATES Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326001160 MD Part B Supplier - Clinic/Group Practice 7719879485 Receives reassigned benefits from 64 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glen Burnie, MD

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

300 Hospital Dr
Ste 126
Glen Burnie, MD 21061
Phone (410) 787-4897

300 Hospital Dr
Ste 132
Glen Burnie, MD 21061
Phone (410) 255-1600

305 Hospital Dr
Ste 460
Glen Burnie, MD 21061
Phone (410) 553-8160

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1821277856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64584",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615803",
            "telephone_number": "410-787-4594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALTIMORE WASHINGTON PROFESSIONAL SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "NOEL",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "MANAGED CARE COORDINATOR",
        "authorized_official_telephone_number": "410-787-4594"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "ZEZT",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "165767",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Q818",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "DB3GBW",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BWMC SURGICAL ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; 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.