Individual provider Active NPI

Lauren Rinaca Condon, P.A.-C

  • Physician Assistant
  • Timonium, MD
National Provider Identifier
1992057194
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0004876 Issued in MD
Practice address
1 Texas Station Court, Suite 300
Timonium, MD 21093
Phone
(410) 683-4102
Fax
(410) 683-2130
NPI assigned
Oct 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0004876 MD Primary
Surgical Physician Assistant 363AS0400X

Addresses

Primary practice location

1 Texas Station Court, Suite 300
Timonium, MD 21093

Mailing address

1 Texas Station Court, Suite 300
Timonium, MD 21093
Phone (410) 683-4102

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
I20150209000575 MD Practitioner - Physician Assistant 6103141403 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Orthopaedic Associates PA CurrentSince Apr 17, 2017 Accepting new patients
University of Maryland Orthopaedic Associates P a CurrentSince Apr 17, 2017 Accepting new patients
St Paul Place Specialists, Inc. Physician Assistant CurrentSince Dec 23, 2014 Accepting new patients
St Paul Place Specialists Inc CurrentSince Dec 23, 2014 Accepting new patients
L & W Pediatrics PA Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

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

2200 Kernan Dr
Ste 1154
Gwynn Oak, MD 21207
Phone (410) 448-6332

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

1 Texas Station Ct
Ste 300
Timonium, MD 21093
Phone (410) 683-2110

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1992057194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TEXAS STATION COURT, SUITE 300",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "21093",
            "telephone_number": "410-683-4102",
            "fax_number": "410-683-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TEXAS STATION COURT, SUITE 300",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "21093",
            "telephone_number": "410-683-4102",
            "fax_number": "410-683-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDON",
        "first_name": "LAUREN",
        "middle_name": "RINACA",
        "name_prefix": "Ms.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-11",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0004876",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Timonium, MD

Sources for this page

Verify at the official NPI Registry.