NPIMap

Organization Active NPI

St Paul Place Specialists, Inc.

  • Orthopaedic Surgery Physician
  • Baltimore, MD
National Provider Identifier
1851405187
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ST PAUL PLACE SPECIALISTS, INC.
Practice address
301 St Paul Place
Medical Staff Office
Baltimore, MD 21202
Phone
(410) 659-2802
NPI assigned
Aug 17, 2006
Last updated
Dec 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Authorized official

Name
Justin Deibel
Title
Executive Vice President & Cfo
Phone
(410) 659-2905

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X
Optometrist 152W00000X
Ophthalmology Physician 207W00000X
Orthopaedic Surgery Physician 207X00000X Primary
Surgery Physician 208600000X
Urology Physician 208800000X

Addresses

Primary practice location

301 St Paul Place
Medical Staff Office
Baltimore, MD 21202

Mailing address

PO Box 824173
Philadelphia, PA 19182-4173

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031202000084 MD Part B Supplier - Clinic/Group Practice 7719882943 Receives reassigned benefits from 568 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Towson, MD; Baltimore, MD; Randallstown, MD; Pikesville, MD; Lutherville Timonium, MD; Lutherville, MD; Laurel, MD; Glen Burnie, MD…

Other NPIs on the same Medicare enrollment 20

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

View all 20

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 63

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 63

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1851405187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 824173",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191824173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ST PAUL PLACE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21202",
            "telephone_number": "410-659-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST PAUL PLACE SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "DEIBEL",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "410-659-2905"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Dec 18, 2024; 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.