Individual provider Active NPI

Michael Joseph Mininsohn, M.D.

  • Hospitalist Physician
  • Baltimore, MD
National Provider Identifier
1942295886
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
D31189 Issued in MD
Practice address
8813 Waltham Woods Rd
Suite 104
Baltimore, MD 21234-2450
Phone
(410) 661-4060
Fax
(410) 661-5349
NPI assigned
Sep 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D31189 MD
Hospitalist Physician 208M00000X D31189 MD Primary

Addresses

Primary practice location

8813 Waltham Woods Rd
Suite 104
Baltimore, MD 21234-2450

Mailing address

8813 Waltham Woods Rd
Suite 104
Baltimore, MD 21234-2450
Phone (410) 661-4060

Other identifiers 1

IdentifierTypeStateIssuer
378161500MedicaidMD

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
I20070615000121 MD Practitioner - Internal Medicine 8628177623 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D31189MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Dec 1, 2012 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Dec 1, 2012 Accepting new patients
Saint Joseph Medical Center , Inc. Past Accepting new patients
St. Joseph Physician Enterprise Past Accepting new patients
Michael J Mininsohn, MD, PA Internal Medicine Past Accepting new patients

Locations

7505 Osler Dr
Ste 204
Towson, MD 21204
Phone (410) 427-5555

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

Interoperability endpoints

  • Direct secure messaging: mmininsohn108649@direct.umm.edu

Organizations & group practices 5

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": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1942295886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8813 WALTHAM WOODS RD",
            "address_2": "SUITE 104",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212342450",
            "telephone_number": "410-661-4060",
            "fax_number": "410-661-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8813 WALTHAM WOODS RD",
            "address_2": "SUITE 104",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212342450",
            "telephone_number": "410-661-4060",
            "fax_number": "410-661-5349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MININSOHN",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D31189",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MD",
            "license": "D31189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378161500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.