Individual provider Active NPI

Irina Medwin, M.D.

  • Internal Medicine Physician
  • Towson, MD
National Provider Identifier
1902124167
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D74067 Issued in MD
Practice address
6701 N Charles St
Kaiser Permanente Greater Baltimore Medical Center
Towson, MD 21204-6808
Phone
(443) 849-2000
NPI assigned
May 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101251959 VA
Internal Medicine Physician 207R00000X MD040709 DC
Internal Medicine Physician 207R00000X D74067 MD Primary

Addresses

Primary practice location

6701 N Charles St
Kaiser Permanente Greater Baltimore Medical Center
Towson, MD 21204-6808

Mailing address

2101 E Jefferson St
Kaiser Permanente Medicare Enrollment
Rockville, MD 20852-4908
Phone (301) 816-2424

Other names 1

  • Irina Medvedeva Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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
I20140411001004 MD Practitioner - Internal Medicine 5395977003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

6701 N Charles St
Baltamore, MD 21204-6808
Phone (443) 849-2000

Hospital & facility affiliations

  • University of MD Baltimore Washington Medical Center Hospital, Glen Burnie, MD, CCN 210043
  • University of MD St Joseph Medical Center Hospital, Towson, MD, CCN 210063

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD040709DCMDInternal Medicine Physician
D74067MDMDInternal Medicine Physician
0101251959VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 29, 2014 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 29, 2014 Accepting new patients
University of Maryland St. Joseph Medical Center, LLC Past Accepting new patients
Baltimore Washington Medical Center Inc. Past Accepting new patients

Locations

2101 E Jefferson St
Rockville, MD 20852
Phone (301) 816-6660

2101 E Jefferson St
#4E
Rockville, MD 20852

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

Interoperability endpoints

  • Direct secure messaging: imedwin539997@direct.umm.edu

Organizations & group practices 4

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 2

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": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1902124167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST",
            "address_2": "KAISER PERMANENTE MEDICARE ENROLLMENT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 N CHARLES ST",
            "address_2": "KAISER PERMANENTE GREATER BALTIMORE MEDICAL CENTER",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212046808",
            "telephone_number": "443-849-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDWIN",
        "first_name": "IRINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2022-01-07",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101251959",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD040709",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D74067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6701 N Charles St",
            "address_2": "Kaiser Permanente Greater Baltimore Medical Center",
            "city": "Towson",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212046808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "IRINA",
            "last_name": "MEDVEDEVA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.