NPIMap

Individual provider Active NPI

Nicholas Theodore, MD

  • Neurological Surgery Physician
  • Baltimore, MD
National Provider Identifier
1982699567
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
D81128 Issued in MD
Practice address
600 N Wolfe St
Meyer 7109
Baltimore, MD 21287-0005
Phone
(410) 955-4424
NPI assigned
Sep 20, 2005
Last updated
Jul 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X D81128 MD Primary

Addresses

Primary practice location

600 N Wolfe St
Meyer 7109
Baltimore, MD 21287-0005

Mailing address

PO Box 64286
Baltimore, MD 21264-4286

Other identifiers 1

IdentifierTypeStateIssuer
738693MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100208000599 AZ Practitioner - Neurosurgery 4082757406 Reassigns benefits to 1 organization
I20160728001597 MD Practitioner - Neurosurgery 4082757406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Georgetown University School of Medicine, 1991
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

4940 Eastern Ave
Baltimore, MD 21224-2735
Phone (410) 550-0100

600 N Wolf St
Baltimore, MD 21287-0005
Phone (410) 955-5000

600 N Wolfe St
Blalock 266
Baltimore, MD 21287-0005
Phone (410) 502-4340

601 N Caroline St
Baltimore, MD 21287-0006
Phone (410) 955-5080

755 E McDowell Rd
Phoenix, AZ 85006-2506
Phone (602) 521-3086

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion86
Laminectomy or laminotomy (partial removal of spine bones)51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D81128MDMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Oct 1, 2025 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Oct 1, 2025 Accepting new patients
Johns Hopkins University CurrentSince Jul 1, 2016 Accepting new patients
Banner - University Physician Specialists LLC Current Accepting new patients
Johns Hopkins University Neurological Surgery CurrentSince Jul 1, 2016 Accepting new patients
Johns Hopkins University Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

4200 E Camelback Rd
Ste 202
Phoenix, AZ 85018
Phone (602) 229-2150

755 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 271-5111

600 N Wolfe St
Baltimore, MD 21287

600 N Wolfe St
#7109
Baltimore, MD 21287
Phone (410) 955-4424

Interoperability endpoints

  • Direct secure messaging: nicholas.theodore@764.direct.myezyaccess.com

Organizations & group practices 7

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 5

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1982699567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64286",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "address_2": "MEYER 7109",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODORE",
        "first_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MD",
            "license": "D81128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "738693",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.