Provider Demographics
NPI:1609195320
Name:JOHNS HOPKINS REGIONAL PHYSICIANS LLC
Entity Type:Organization
Organization Name:JOHNS HOPKINS REGIONAL PHYSICIANS LLC
Other - Org Name:CARDIOVASCULAR SPECIALISTS OF CENTRAL MARYLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:JHRP BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-760-8840
Mailing Address - Street 1:PO BOX 412709
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2709
Mailing Address - Country:US
Mailing Address - Phone:410-760-8840
Mailing Address - Fax:
Practice Address - Street 1:10710 CHARTER DR
Practice Address - Street 2:STE 400
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044
Practice Address - Country:US
Practice Address - Phone:443-276-9000
Practice Address - Fax:443-276-9610
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHNS HOPKINS REGIONAL PHYSICIANS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCRZ1CAOtherCAREFIRST OF MARYLAND
MDV879OtherCAREFIRST GHMSI AND BLUE CHOICE
MD440200600Medicaid
MDDR1793OtherRAILROAD MEDICARE
MD440200600Medicaid