THE GOOD SAMARITAN HOSPITAL OF MARYLAND, INC. (NPI# 1568694875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568694875 |
| Entity Type | Organization |
| Organization Name | THE GOOD SAMARITAN HOSPITAL OF MARYLAND, INC. |
| Practice Address |
5601 Loch Raven Blvd Baltimore MD 21239-2905 |
| Practice Telephone | 4434448000 |
| Mailing Telephone | 4434448000 |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-08-20 |
| Authorized Official Name | DEANA STOUT (V. P. OF FINANCE) |
| Authorized Official Telephone | 4434443841 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | CAREFIRST BC/BS MD | KU88GO | 01 |
| MD | CAREFIRST BC/BS DC | M688 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114351863 | The Good Samaritan Hospital of Maryland, Inc. | Clinic/Center | 1046 S Northpoint Rd, Baltimore, MD 21224-3307 | 2013-08-29 |
| 1306112693 | The Good Samaritan Hospital of Maryland, Inc. | Clinic/Center | 4700 Hartford Road, Baltimore, MD 21214 | 2012-03-30 |
| 1437396959 | The Good Samaritan Hospital of Maryland, Inc. | Dietitian, Registered | 5601loch Raven Blvd., Baltimore, MD 21239-2095 | 2009-01-21 |
| 1154647303 | The Good Samaritan Hospital of Maryland, Inc. | Internal Medicine | 5601 Loch Raven Blvd, Baltimore, MD 21239-2905 | 2010-04-13 |
| 1881910032 | The Good Samaritan Hospital of Maryland, Inc. | Internal Medicine | 5601 Loch Raven Blvd, Baltimore, MD 21239-2905 | 2010-04-13 |
| 1740503945 | The Good Samaritan Hospital of Maryland, Inc. | Counselor | 5601 Loch Raven Blvd, Russell Morgan Building, Suite 406, Baltimore, MD 21239-2905 | 2010-03-03 |
| 1528290830 | The Good Samaritan Hospital of Maryland, Inc. | Internal Medicine | 5601 Loch Raven Blvd, Baltimore, MD 21239-2905 | 2009-08-20 |
| 1942432257 | The Good Samaritan Hospital of Maryland, Inc. | Surgery | 5601 Loch Raven Blvd, Pob, Suite 106, Baltimore, MD 21239-2905 | 2009-08-20 |
| 1801028105 | The Good Samaritan Hospital of Maryland, Inc. | Internal Medicine | 5601 Loch Raven Blvd, Rmb, Suite 103, Baltimore, MD 21239-2905 | 2009-08-20 |
| 1225276702 | The Good Samaritan Hospital of Maryland, Inc. | Psychiatry & Neurology | 5601 Loch Raven Blvd, Baltimore, MD 21239-2905 | 2009-01-22 |
| Street Address |
5601 LOCH RAVEN BLVD |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21239-2905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316940588 | Paul Byron Fowler | Specialist | 5601 Loch Raven Blvd, Baltimore, MD 21239-2905 | 2005-05-23 |
| 1992328017 | Kaitlin Lee | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-05-22 |
| 1023646692 | Akiko Rockers | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-03-30 |
| 1578199519 | Erica Wilson | Pharmacist | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-03-22 |
| 1154952497 | Kimberly Jo Jenko | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-01-27 |
| 1679103576 | Nerland Dimanche | Registered Nurse | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-01-20 |
| 1063058782 | Simcha Gratz | Nurse Practitioner | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-11-19 |
| 1548817737 | Christopher Burgess | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-08-22 |
| 1114571809 | Lauren Delmonico | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-07-30 |
| 1750943411 | Sana Tanveer Ahmed | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-07-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255809273 | Books of Color, LLC | Student in an Organized Health Care Education/Training Program | 1222 Walker Ave, Baltimore, MD 21239 | 2018-11-07 |
| 1902381353 | Brandon Wilson | Physician Assistant | 5601 Lochraven Blvd, Baltimore, MD 21239 | 2018-10-02 |
| 1629563879 | Ashley C Sayles | Nurse Practitioner | 5601 Loch Raven Blvd Ste 200, Baltimore, MD 21239 | 2018-06-28 |
| 1164940656 | Tarnisha Fitzgerald | Nurse Practitioner | 1601 East Belvedere Avenue, Baltimore, MD 21239 | 2017-09-05 |
| 1083153803 | J.pope & Associates, LLC | Counselor | 1800 E. Northern Pkwy #28031, Baltimore, MD 21239 | 2017-02-13 |
| 1417336017 | Mana Ali | Psychologist | 5601 Loch Raven Blvd Ste 406, Johns Hopkins Som Dept of Physical Med and Rehab, Baltimore, MD 21239 | 2015-05-28 |
| 1730597766 | Ramona Taylor-knox | Counselor | 1700 Meridian Drive, Suite 611, Baltimore, MD 21239 | 2014-07-22 |
| 1013259142 | Innovative Healing Solutions,llc | Social Worker | 1302 Silverthorne Rd, Baltimore, MD 21239 | 2013-03-27 |
| 1962744268 | Mohamad Hanouneh | Internal Medicine | 5601 Loch Raven Blvd Ste 3n, Baltimore, MD 21239 | 2013-03-25 |
| 1164713350 | Vanessa G Brown | Pharmacist | 5618 The Alameda, Baltimore, MD 21239 | 2011-04-22 |
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| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285815530 | Bay Vascular Surgery, LLC | Surgery | 3623 Falls Rd, Baltimore, MD 21211-1815 | 2007-11-15 |
| 1811042641 | Kevin Arthur Brown | Surgery | 3333 N Calvert St Ste 325, Baltimore, MD 21218-2866 | 2007-01-24 |
| 1881625564 | Brajesh Kumar Lal | Surgery | 22 S Greene St # N4w66, Baltimore, MD 21201-1544 | 2006-07-05 |
| 1790757847 | Fayyaz Haider Hashmi | Surgery | 2435 W Belvedere Ave Ste 35, Baltimore, MD 21215-5224 | 2006-02-03 |
| 1528402252 | Sarasijhaa K Desikan | Surgery | 419 W Redwood St Ste 300, Baltimore, MD 21201 | 2013-04-24 |
| 1710245931 | Jason Andrew Chin | Surgery | 3333 N Calvert St, Johnston Professional Building 325, Baltimore, MD 21218-2850 | 2012-04-25 |
| 1356607139 | Caitlin Whitney Hicks | Surgery | 600 N Wolfe St, Halsted 668, Baltimore, MD 21287-0005 | 2012-04-06 |
| 1043530553 | Michael R Hall | Surgery | 22 S Greene St, Baltimore, MD 21201-1544 | 2010-06-07 |
| 1629208749 | Alain Tanbe | Surgery | 301 Saint Paul St, Baltimore, MD 21202-2102 | 2009-07-23 |
| 1467686428 | Sira Mary Duson | Surgery | 22 S Greene St # S10b00, Baltimore, MD 21201-1544 | 2009-05-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.