Individual provider Active NPI

Michael Radowsky, MD

  • Dermatology Physician
  • Baltimore, MD
National Provider Identifier
1992799027
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
D0022594 Issued in MD
Practice address
5601 Loch Raven Blvd
Good Samaritan Hospital Suite 206
Baltimore, MD 21239-2905
Phone
(410) 433-4445
Fax
(410) 433-0504
NPI assigned
Sep 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X D0022594 MD Primary

Addresses

Primary practice location

5601 Loch Raven Blvd
Good Samaritan Hospital Suite 206
Baltimore, MD 21239-2905

Mailing address

8606 Snowreath Rd
Pikesville, MD 21208-6337
Phone (410) 484-8486

Other identifiers 2

IdentifierTypeStateIssuer
511000944MedicaidMD
777451500MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0022594MDMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin Square Hospital Center, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1125878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1992799027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8606 SNOWREATH RD",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212086337",
            "telephone_number": "410-484-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "GOOD SAMARITAN HOSPITAL SUITE 206",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392905",
            "telephone_number": "410-433-4445",
            "fax_number": "410-433-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOWSKY",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-05",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0022594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "511000944",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "777451500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.