NPIMap

Organization Active NPI

Chesapeake Urology Associates, LLC

  • Urology Physician
  • Baltimore, MD
National Provider Identifier
1821813692
Registry record updated Mar 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
CHESAPEAKE UROLOGY ASSOCIATES, LLC
Practice address
3407 Wilkens Ave Ste 210
Baltimore, MD 21229-5221
Phone
(410) 644-0929
NPI assigned
Nov 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2025

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

Authorized official

Name
Sanford Jay Siegel, MDNPI 1376506477
Title
President
Phone
(410) 581-1600

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
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

3407 Wilkens Ave Ste 210
Baltimore, MD 21229-5221

Mailing address

10200 Grand Central Ave Ste 220
Owings Mills, MD 21117-4366
Phone (443) 738-2872

Other identifiers 1

IdentifierTypeStateIssuer
276600105MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040510000449 MD Part B Supplier - Clinic/Group Practice 4789673393 Receives reassigned benefits from 195 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Westminster, MD; Towson, MD; Stevensville, MD; Salisbury, MD; Owings Mills, MD; Havre de Grace, MD; Hanover, MD; Glen Burnie, MD…

Other NPIs on the same Medicare enrollment 22

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

View all 22

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0915249Chesapeake Urology Associates LLC3407 Wilkens Avenue #210, Baltimore, MD 21229Certificate of waiverMay 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
Chesapeake Urol Assoc LLC40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741392000000",
    "number": "1821813692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 GRAND CENTRAL AVE STE 220",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174366",
            "telephone_number": "443-738-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 WILKENS AVE STE 210",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295221",
            "telephone_number": "410-644-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE UROLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-08",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "SANFORD",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-581-1600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276600105",
            "state": "MD"
        }
    ],
    "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 Mar 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.