Individual provider Active NPI

Maria Shesiuk

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1831442193
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C04925 Issued in MD
Practice address
620 N Caroline St
Baltimore, MD 21205-1839
Phone
(410) 396-9410
NPI assigned
Oct 23, 2012
Last updated
Mar 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C04925 MD Primary

Addresses

Primary practice location

620 N Caroline St
Baltimore, MD 21205-1839

Mailing address

3211 Mary Ave
Baltimore, MD 21214-2016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130503000401 MD Practitioner - Physician Assistant 9739326018 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrative Health Practices LLCGroup PAC ID 2163798299, 4 clinicians

Practice addresses (Care Compare)

9501 Old Annapolis Rd
Suite 205
Ellicott City, MD 21042-6336
Phone (410) 648-2555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Hospital Center, Inc. CurrentSince Mar 13, 2013 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Jun 11, 2015 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Jun 11, 2015 Accepting new patients
Northwest Hospital Center, Inc Physician Assistant CurrentSince Mar 13, 2013 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1831442193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 MARY AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212142016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N CAROLINE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051839",
            "telephone_number": "410-396-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHESIUK",
        "first_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-23",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C04925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.