NPIMap

Organization Active NPI

Ellicott City Pediatric Assoc

  • Pediatrics Physician
  • Ellicott City, MD
National Provider Identifier
1831152727
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ELLICOTT CITY PEDIATRIC ASSOC
Practice address
9011 Chevrolet Drive
Suite 1-6
Ellicott City, MD 21042-4024
Phone
(410) 465-7550
Fax
(410) 465-7085
NPI assigned
Apr 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Authorized official

Name
Dr. Oliver Custodio Galita, MDNPI 1346206489
Title
Ownder
Phone
(410) 465-7550

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

9011 Chevrolet Drive
Suite 1-6
Ellicott City, MD 21042-4024

Mailing address

9011 Chevrolet Drive
Suite 1-6
Ellicott City, MD 21042-4024
Phone (410) 465-7550

Other identifiers 1

IdentifierTypeStateIssuer
967551500MedicaidMD

Other names 1

  • Dr. Leffler Cahill & Berger PA. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Dr Leffler Cahill Berger PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

9011 Chevrolet Dr
Ste 16
Ellicott City, MD 21042
Phone (410) 465-7550

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": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666828800000",
    "number": "1831152727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9011 CHEVROLET DRIVE",
            "address_2": "SUITE 1-6",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210424024",
            "telephone_number": "410-465-7550",
            "fax_number": "410-465-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9011 CHEVROLET DRIVE",
            "address_2": "SUITE 1-6",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210424024",
            "telephone_number": "410-465-7550",
            "fax_number": "410-465-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLICOTT CITY PEDIATRIC ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A",
        "authorized_official_last_name": "GALITA",
        "authorized_official_first_name": "OLIVER",
        "authorized_official_middle_name": "CUSTODIO",
        "authorized_official_title_or_position": "OWNDER",
        "authorized_official_telephone_number": "410-465-7550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "967551500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Leffler Cahill & Berger PA.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Dr. Leffler Cahill & Berger PA.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.