Individual provider Active NPI

Shamus Russell Carr, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Baltimore, MD
National Provider Identifier
1891727913
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
D78550 Issued in MD
Practice address
29 S Greene St
Stoler Cancer Pavilion
Baltimore, MD 21201-1504
Phone
(410) 332-8663
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD418012 PA
Surgery Physician 208600000X 8054539-1205 UT
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 8054539-1205 UT
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X D78550 MD Primary

Addresses

Primary practice location

29 S Greene St
Stoler Cancer Pavilion
Baltimore, MD 21201-1504

Mailing address

PO Box 64226
Baltimore, MD 21264-4226
Phone (667) 214-1720

Other identifiers 1

IdentifierTypeStateIssuer
085578200MedicaidMD

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
I20141211000293 MD Practitioner - Vascular SurgeryPractitioner - General Surgery 4183897002 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD418012PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Surgical Associates, PA CurrentSince Oct 15, 2014 Accepting new patients
University of Utah Cardiothoracic Surgery PastSince Sep 1, 2000 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

419 W Redwood St
Fl 3
Baltimore, MD 21201
Phone (410) 328-5300

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1891727913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64226",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644226",
            "telephone_number": "667-214-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 S GREENE ST",
            "address_2": "STOLER CANCER PAVILION",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011504",
            "telephone_number": "410-332-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "SHAMUS",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD418012",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "8054539-1205",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "UT",
            "license": "8054539-1205",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MD",
            "license": "D78550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085578200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.