Medspa M.D. LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

D0060902 Issued in MD

Legal business name

MEDSPA M.D. LLC

Practice address

1804 W North Ave
Baltimore, MD 21217-1621

Phone

(410) 685-6331

Fax

(410) 685-6332

NPI assigned

Jul 18, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Susan Renee Clanzy, M.D.NPI 1568435634

Title

Ceo

Phone

(410) 446-2257

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Renee Clanzy, M.D.

  • General Practice Physician
  • Baltimore, MD
  • NPI 1568435634
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1871848614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 W NORTH AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212171621",
            "telephone_number": "410-685-6331",
            "fax_number": "410-685-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 W NORTH AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212171621",
            "telephone_number": "410-685-6331",
            "fax_number": "410-685-6332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSPA M.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "CLANZY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-446-2257",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "MD",
            "license": "D0060902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylyn Medley
• Alexis Marie Medlin
• Steven Murray Mednick
• Kesta Medoit, LCPC
• Medop Behavioral Health Associates of Maryland PC
• Medstar
• Medstar Family Choice, Inc
• Medstar Franklin Square Medical Center
• Medstar Franklin Square Medical Center
• Medstar Franklin Square Medical Center

• General Practice Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• General Practice Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; 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.