Individual provider Active NPI

Gary William Pushkin, M.D.

  • Specialist
  • Baltimore, MD
National Provider Identifier
1871587212
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0024470 Issued in MD
Practice address
2506 Saint Paul Street
Baltimore, MD 21218
Phone
(410) 235-3300
Fax
(410) 366-1260
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D0024470 MD Primary
Specialist 174400000X MD60569954 WA

Addresses

Primary practice location

2506 Saint Paul Street
Baltimore, MD 21218

Mailing address

2506 Saint Paul Street
Baltimore, MD 21218
Phone (410) 235-3300

Other identifiers 1

IdentifierTypeStateIssuer
377641700MedicaidMD

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
I20081013000378 MD Practitioner - Orthopedic Surgery 2668540055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2506 Saint Paul St
Baltimore, MD 21218-4609
Phone (410) 235-3300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0024470MDMDSpecialist
MD60569954WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Cohen & Pushkin, M.D., P.a. Specialist CurrentSince Oct 1, 1995 Accepting new patients
MDDC, LLC Past Accepting new patients

Locations

2506 Saint Paul St
Baltimore, MD 21218
Phone (410) 235-3300

8028 Ritchie Hwy
Ste 207
Pasadena, MD 21122
Phone (410) 296-6232

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.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1871587212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 SAINT PAUL STREET",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21218",
            "telephone_number": "410-235-3300",
            "fax_number": "410-366-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 SAINT PAUL STREET",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21218",
            "telephone_number": "410-235-3300",
            "fax_number": "410-366-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUSHKIN",
        "first_name": "GARY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0024470",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD60569954",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377641700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.