Individual provider Active NPI

Maryellen R Goodell, MD

  • Family Medicine Physician
  • Baltimore, MD
National Provider Identifier
1841244167
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0066900 Issued in MD
Practice address
9101 Franklin Square Dr
Suite 205
Baltimore, MD 21237-3936
Phone
(443) 777-2000
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0066900 MD Primary

Addresses

Primary practice location

9101 Franklin Square Dr
Suite 205
Baltimore, MD 21237-3936

Mailing address

9101 Franklin Square Dr
Suite 205
Baltimore, MD 21237-3936
Phone (443) 777-2000

Other identifiers 2

IdentifierTypeStateIssuer
33345400MedicaidWI
002006261WOtherHUMANA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080609000037 MD Practitioner - Family Practice 0143390757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Duke University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440

Hospital & facility affiliations

  • Medstar Health Home Care Home health agency, Baltimore, MD, CCN 217068

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0066900MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Mar 1, 2023 Accepting new patients
Medstar Medical Group II LLC CurrentSince Mar 1, 2023 Accepting new patients

Locations

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

9101 Franklin Square Dr
Ste 205
Rosedale, MD 21237
Phone (410) 682-7000

9101 Franklin Square Dr
Rosedale, MD 21237
Phone (443) 777-2000

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

9101 Franklin Square Dr
Ste 300
Rosedale, MD 21237
Phone (443) 777-2000

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1841244167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 FRANKLIN SQUARE DR",
            "address_2": "SUITE 205",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373936",
            "telephone_number": "443-777-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 FRANKLIN SQUARE DR",
            "address_2": "SUITE 205",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373936",
            "telephone_number": "443-777-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODELL",
        "first_name": "MARYELLEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0066900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33345400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "002006261W",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.