Provider Demographics
| NPI: | 1801102504 |
|---|---|
| Name: | GREATER METROPOLITAN ORTHOPAEDIC INSTITUTE |
| Entity type: | Organization |
| Organization Name: | GREATER METROPOLITAN ORTHOPAEDIC INSTITUTE |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JEFFREY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | SABLOFF |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 301-719-1169 |
| Mailing Address - Street 1: | 8926 WOODYARD RD |
| Mailing Address - Street 2: | SUITE 701 |
| Mailing Address - City: | CLINTON |
| Mailing Address - State: | MD |
| Mailing Address - Zip Code: | 20735-4220 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 301-856-1682 |
| Mailing Address - Fax: | 301-856-8214 |
| Practice Address - Street 1: | 11325 PEMBROOKE SQ |
| Practice Address - Street 2: | |
| Practice Address - City: | WALDORF |
| Practice Address - State: | MD |
| Practice Address - Zip Code: | 20603-4807 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 301-856-1682 |
| Practice Address - Fax: | 301-843-2946 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2010-08-19 |
| Last Update Date: | 2011-03-18 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | Group - Multi-Specialty |
| No | 207XS0106X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | Group - Multi-Specialty |
| No | 207XS0117X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | Group - Multi-Specialty |
| No | 207XX0004X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Foot and Ankle Surgery | Group - Multi-Specialty |
| No | 2081P2900X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine | Group - Multi-Specialty |
| No | 208VP0000X | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | Group - Multi-Specialty |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| 176608 | Other | METRO MEDICARE | |
| DG8302 | Other | RAILROAD MEDICARE | |
| 2803674 | Other | AETNA GROUP PROVIDER # WALDORF LOCATION | |
| S176 | Other | CAREFIRST MARYLAND | |
| 145530100 | Other | DEPARTMENT OF LABOR | |
| 462L | Other | MARYLAND MEDICARE | |
| 4695 | Other | CAREFIRST BCBS OF DC | |
| 2803674 | Other | AETNA GROUP PROVIDER # WALDORF LOCATION | |
| DG8302 | Other | RAILROAD MEDICARE | |
| I60636 | Medicare UPIN | ||
| I20600 | Medicare UPIN | ||
| 0254450005 | Medicare NSC | ||
| S176 | Other | CAREFIRST MARYLAND | |
| B92844 | Medicare UPIN | ||
| B93412 | Medicare UPIN | ||
| G86663 | Medicare UPIN | ||
| CI2264 | Medicare PIN | ||
| 4695 | Other | CAREFIRST BCBS OF DC | |
| E61710 | Medicare UPIN |
