Organization Active NPI

Greenspring Personal Medicine, LLC

  • Internal Medicine Physician
  • Lutherville, MD
National Provider Identifier
1982329926
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GREENSPRING PERSONAL MEDICINE, LLC
Practice address
2328 W Joppa Rd Ste 310
Lutherville, MD 21093-4685
Phone
(410) 616-2804
Fax
(410) 583-7147
NPI assigned
Oct 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Authorized official

Name
Jeffrey Magaziner, MDNPI 1881638377
Title
Member
Phone
(410) 718-4840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2328 W Joppa Rd Ste 310
Lutherville, MD 21093-4685

Mailing address

2328 W Joppa Rd Ste 310
Lutherville, MD 21093-4685
Phone (410) 616-2804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221229001301 MD Part B Supplier - Clinic/Group Practice 7517337918 Receives reassigned benefits from 6 practitioners
Practice locations: Lutherville, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2282125Greenspring Personal Medicine2328 W Joppa Rd Suite 310, Lutherville, MD 21093Certificate of waiverMay 16, 2027

National Provider Directory

National Provider Directory

Locations

2328 W Joppa Rd
Lutherville, MD 21093
Phone (410) 296-8050

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1982329926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 W JOPPA RD STE 310",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210934685",
            "telephone_number": "410-616-2804",
            "fax_number": "410-583-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2328 W JOPPA RD STE 310",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210934685",
            "telephone_number": "410-616-2804",
            "fax_number": "410-583-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENSPRING PERSONAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-11",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "MAGAZINER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "410-718-4840",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.