Individual provider Active NPI

Cassidy Pickles, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1912504705
Registry record updated Jan 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0007719 Issued in MD
Practice address
2401 W Belvedere Ave
Baltimore, MD 21215-5216
Phone
(410) 601-9000
NPI assigned
Oct 5, 2020
Last updated
Jan 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0007719 MD Primary

Addresses

Primary practice location

2401 W Belvedere Ave
Baltimore, MD 21215-5216

Mailing address

2401 W Belvedere Ave
Baltimore, MD 21215-6945

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210120001882 MD Practitioner - Physician Assistant 1658785357 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-1230

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0007719MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore, Inc. CurrentSince Dec 16, 2020 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Dec 16, 2020 Accepting new patients
University of Maryland Oncology Associates, PA CurrentSince Aug 22, 2023 Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

2401 W Belvedere Ave
Baltimore, MD 21215

5051 Greenspring Ave
Baltimore, MD 21209
Phone (410) 601-1441

5415 Old Court Rd
Ste S04
Randallstown, MD 21133
Phone (410) 701-4437

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611964800000",
    "number": "1912504705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212156945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKLES",
        "first_name": "CASSIDY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-05",
        "last_updated": "2021-01-30",
        "certification_date": "2021-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0007719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.