Chesapeake Urology Associates, LLC
Organization Active NPI Urology Physician · Baltimore, MD
NPI 1992520795 · NPPES record last updated Mar 8, 2025
Key facts
- NPI
- 1992520795
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urology Physician 208800000X
- Legal business name
- CHESAPEAKE UROLOGY ASSOCIATES, LLC
- Practice address
- 6820 Hospital Dr Ste 210
Baltimore, MD 21237-4360 - Phone
- (410) 391-6131
- NPI assigned
- Nov 18, 2024
- Organization subpart
- No
Authorized official
- Name
- Sanford Jay Siegel, MD
- Title
- President
- Phone
- (410) 581-1600
Other NPIs on the same Medicare enrollment 22
Corporate family (same tax ID) 39
Practitioners 6
-
Michael Larkin Adashek, D.O.
-
Yudhishtra Markan, M.D.
-
Lindsay G Nelms, PA-C
-
Afia Esther Ewoo, CRNP
-
Sanford Jay Siegel, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D0716819 | Chesapeake Urology Associates PA | Certificate of waiver | Feb 29, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040510000449 | MD | Part B Supplier - Clinic/Group Practice | 4789673393 |
Receives reassigned benefits from 195 practitioners 22 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Westminster, MD; Towson, MD; Stevensville, MD; Salisbury, MD; Owings Mills, MD; Havre de Grace, MD; Hanover, MD; Glen Burnie, MD… |
National Provider Directory
- Tax ID family
- Chesapeake Urol Assoc LLC
Locations
6820 Hospital Dr
Ste 200
Rosedale, MD 21237
Phone (410) 391-6131
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician |
208800000X | Yes |
Addresses
Primary practice location
6820 Hospital Dr Ste 210
Baltimore, MD 21237-4360
Mailing address
10200 Grand Central Ave Ste 220
Owings Mills, MD 21117-4366
Phone (443) 738-2872
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 276600124 | Medicaid | MD |
Other providers in Baltimore, MD
- Chesapeake Urology Associates P.a.
- Chesapeake Urology Associates, LLC
- Chesapeake Urology Associates, LLC
- Chesapeake Urology Associates, LLC
- Chesapeake Urology Associates, LLC
- Chesapeake Urology Associates, PA
- Chesapeake Wellness Collaborative LLC
- Chesapeake Wellness LLC
- Chesapekae Perioperative Services L.L.C.
- Emily Ann Chesbrough
All providers in Baltimore, MD · Urology Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.