Individual provider Active NPI

Marlis Gonzalez-Fernandez, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Baltimore, MD
National Provider Identifier
1861444887
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
D61807 Issued in MD
Practice address
5601 Loch Raven Blvd
Baltimore, MD 21239-2905
Phone
(410) 532-4701
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X D61807 MD Primary

Addresses

Primary practice location

5601 Loch Raven Blvd
Baltimore, MD 21239-2905

Mailing address

PO Box 64407
Baltimore, MD 21264-4407

Other identifiers 1

IdentifierTypeStateIssuer
407206500MedicaidMD

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
I20050426000877 MD Practitioner - Physical Medicine and Rehabilitation 1658310099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

10803 Falls Rd
Lutherville, MD 21093-4502
Phone (410) 616-7645

10803 Falls Rd Pavilion III
Greenspring Station ASC
Lutherville, MD 21093-4502
Phone (410) 955-6108

1800 Orleans St
Baltimore, MD 21287-0010
Phone (410) 955-5000

5501 Hopkins Bayview Cir
Baltimore, MD 21224-6821
Phone (410) 550-0545

5505 Hopkins Bayview Cir
Baltimore, MD 21224-6821
Phone (410) 550-0756

600 N Wolf St
Baltimore, MD 21287-0005
Phone (410) 955-5000

600 N Wolfe St
Blalock 266
Baltimore, MD 21287-0005
Phone (410) 502-4340

601 N Caroline St
Baltimore, MD 21287-0006
Phone (410) 955-5080

6201 Greenleigh Ave
Middle River, MD 21220-2004

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Physical Medicine & Rehabilitation CurrentSince Oct 27, 2004 Accepting new patients
Johns Hopkins University Current Accepting new patients
Johns Hopkins University CurrentSince Oct 27, 2004 Accepting new patients

Locations

5601 Loch Raven Blvd
Ste 406
Baltimore, MD 21239
Phone (410) 532-4540

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

5501 Hopkins Bayview Cir
Baltimore, MD 21224
Phone (410) 550-0545

Interoperability endpoints

  • Direct secure messaging: mgonzalezfernandez35527@direct.hopkinsmedicine.org

Organizations & group practices 3

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1861444887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64407",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392905",
            "telephone_number": "410-532-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-FERNANDEZ",
        "first_name": "MARLIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "D61807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407206500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.