Individual provider Active NPI

Mary Divya Kasu

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1972091668
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0099777 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-6716
Fax
(410) 706-5103
NPI assigned
Apr 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0099777 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

22 S Greene St
Baltimore, MD 21201-1544
Phone (410) 328-6716

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
I20240611000884 MD Practitioner - Pediatric Medicine 6103368758 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Pediatric Associates, PA Pediatrics CurrentSince Jul 1, 2024 Accepting new patients
University of Maryland Pediatric Associates, PA Pediatrics CurrentSince Jul 1, 2024 Accepting new patients
University of Maryland St. Joseph Medical Center, LLC Past Accepting new patients
University of Maryland Medical Center, LLC Past Accepting new patients

Locations

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

22 S Greene St
#N4
Baltimore, MD 21201
Phone (410) 328-6716

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

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

Interoperability endpoints

  • Direct secure messaging: mkasu1144834@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.

NPI Registry JSON

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1972091668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6716",
            "fax_number": "410-706-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6716",
            "fax_number": "410-706-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASU",
        "first_name": "MARY DIVYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-27",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0099777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.