NPIMap

Organization Active NPI

Chesapeake Open MRI L L C

Doing business as Chesapeake Medical Imaging

  • Diagnostic Radiology Physician
  • Baltimore, MD
National Provider Identifier
1851664122
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D44496 Issued in MD
Legal business name
CHESAPEAKE OPEN MRI L L C
Doing business as
Chesapeake Medical Imaging
Practice address
4600 Wilkens Ave
Suite 103
Baltimore, MD 21229-4843
Phone
(410) 242-8335
Fax
(410) 242-8339
NPI assigned
Feb 17, 2012
Last updated
Sep 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Authorized official

Name
Dr. Mark Baganz, M.D.NPI 1982768966
Title
Officer
Phone
(410) 571-0350

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
Diagnostic Radiology Physician 2085R0202X D44496 MD Primary

Addresses

Primary practice location

4600 Wilkens Ave
Suite 103
Baltimore, MD 21229-4843

Mailing address

122 Defense Hwy Ste 102
Annapolis, MD 21401-7044

Other names 1

  • Chesapeake Medical Imaging Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080422000350 MD Part B Supplier - Clinic/Group Practice 9931178373 Receives reassigned benefits from 24 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Easton, MD; Eldersburg, MD; Fulton, MD; Glen Burnie, MD; Lutherville, MD; Stevensville, MD; Chestertown, MD; Columbia, MD…

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Chesapeake Open MRI L L C15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

4600 Wilkens Ave
Ste 103
Baltimore, MD 21229
Phone (410) 242-8335

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1851664122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 DEFENSE HWY STE 102",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017044",
            "fax_number": "410-242-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 WILKENS AVE",
            "address_2": "SUITE 103",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212294843",
            "telephone_number": "410-242-8335",
            "fax_number": "410-242-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE OPEN MRI L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-17",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "BAGANZ",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "410-571-0350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D44496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chesapeake Medical Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 9, 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.