GENESIS ELDERCARE PHYSICIAN SERVICES LLC (NPI# 1184095267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184095267 |
| Entity Type | Organization |
| Organization Name | GENESIS ELDERCARE PHYSICIAN SERVICES LLC |
| Practice Address |
515 Fairmount Ave Towson MD 21286-5466 |
| Mailing Address |
Po Box 42738 Towson MD 21284-2738 |
| Practice Telephone | 4108327790 |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2018-04-13 |
| Authorized Official Name | ERIC SHAPIRO (VP/CONTROLLER) |
| Authorized Official Telephone | 4108327790 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801215041 | Genesis Eldercare Physician Services LLC | Family Medicine | 835 Tenderfoot Hill Rd # T, Colorado Springs, CO 80906 | 2014-04-15 |
| 1033535828 | Genesis Eldercare Physician Services LLC | Nurse Practitioner | 16605 Chestnut Glen Pl, Louisville, KY 40245 | 2014-03-17 |
| 1609180926 | Genesis Eldercare Physician Services LLC | Family Medicine | 6508 Deer Pointe Dr Ste A, Salisbury, MD 21804 | 2010-07-28 |
| 1326148107 | Genesis Eldercare Physician Services LLC | Skilled Nursing Facility | 14233 Alta Oaks Dr, Rockville, MD 20850-7413 | 2006-09-22 |
| 1699710202 | Genesis Eldercare Physician Services LLC | Internal Medicine | 11 Dairy Ln, Fredericksburg, VA 22405-2663 | 2006-06-18 |
| 1881635183 | Genesis Eldercare Physician Services LLC | Internal Medicine | 6508 Deer Pointe Dr, Suite A, Salisbury, MD 21804 | 2006-06-09 |
| 1104819259 | Genesis Eldercare Physician Services LLC | Internal Medicine | 464 Main St, Heritage Hall East, Agawam, MA 01001 | 2005-08-24 |
| 1164415196 | Genesis Eldercare Physician Services LLC | Internal Medicine | 1 Emerson Dr, Kimberly Hall North, Windsor, CT 06095 | 2005-08-24 |
| 1699280511 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286 | 2017-12-14 |
| 1548615313 | Genesis Eldercare Physician Services LLC | Internal Medicine | 7900 Constitution Ave Ne, Albuquerque, NM 87110 | 2016-04-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | GENESIS ELDERCARE PHYSICIAN SERVICES LLC | 101 E State St, Kennett Sq, PA 19348-3109 |
| Street Address |
515 FAIRMOUNT AVE |
| City | TOWSON |
| State | MD |
| Zip Code | 21286-5466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013910454 | David S. Berliner | Internal Medicine | 515 Fairmount Ave, Ste 400, Towson, MD 21286-5466 | 2005-05-31 |
| 1598253403 | Courtney Alyse Mcguire | Occupational Therapy Assistant | 515 Fairmount Ave, Towson, MD 21286-5466 | 2018-04-25 |
| 1699280511 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286 | 2017-12-14 |
| 1497296271 | Candice Korolevich | Nurse Practitioner | 515 Fairmount Ave, Towson, MD 21286 | 2017-03-14 |
| 1124572763 | Gps Physician Group of Texas Pllc | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286-5466 | 2016-08-11 |
| 1659737898 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286-5466 | 2016-01-04 |
| 1104297852 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286-5466 | 2015-10-07 |
| 1982074001 | Clinical Associates P A | Clinic/Center | 515 Fairmount Ave, Ste 100a, Towson, MD 21286-5466 | 2015-10-01 |
| 1417344284 | Genesis Staffing Services, LLC | Community/Behavioral Health | 515 Fairmount Ave, 8th Floor, Towson, MD 21286-5466 | 2015-04-20 |
| 1699172387 | Lifebridge Multi-specialty. LLC | Dermatology | 515 Fairmount Ave, Towson, MD 21286-5466 | 2014-11-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750989042 | Osereme Nora Agboifo | Nurse Practitioner | 200 Ejoppa Rd Suite 106, Townson, MD 21286 | 2020-10-09 |
| 1801434543 | Bh Brightview Towson Opco, LLC | Alzheimer Center (Dementia Center) | 20 E. Burke Avenue, Baltimore, MD 21286 | 2019-12-12 |
| 1417598897 | Tyler Tuggle | Home Health Aide | 8601 Lasalle Rd., Suite 100, Towson, MD 21286 | 2019-10-07 |
| 1285289629 | Center for Creative Values Inc | Community/Behavioral Health | 515 E. Joppa Rd Suite 100 & 104, Towson, MD 21286 | 2019-08-02 |
| 1275195117 | Watermark Health Services | Chore Provider | 1045 Taylor Avenue Suite 106e, Towson, MD 21286 | 2019-07-01 |
| 1609337021 | Tyler James Howard | Psychologist | 8600 Lasalle Road Carroll Building, Suite 212, Towson, MD 21286 | 2019-03-28 |
| 1477019578 | Ruth Marie Collins | Counselor | 8501 Lasalle Rd., Suite 115, Towson, MD 21286 | 2019-02-13 |
| 1396200671 | Christian Dorry | Behavior Technician | Epic Developmental Services, 1026 Cromwell Bridge Rd, Towson, MD 21286 | 2019-01-31 |
| 1831667799 | Casey O'sullivan | Counselor | 1220 E. Joppa Rd., Bldg B, Ste 332, Towson, MD 21286 | 2018-11-08 |
| 1649763053 | Rosemary O Okpulor | Nurse Practitioner | 8510 Lasalle Rd, Suite 310, Towson, MD 21286 | 2018-06-11 |
| Find all providers in zip 21286 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699280511 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286 | 2017-12-14 |
| 1124572763 | Gps Physician Group of Texas Pllc | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286-5466 | 2016-08-11 |
| 1659737898 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286-5466 | 2016-01-04 |
| 1104297852 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286-5466 | 2015-10-07 |
| 1427209972 | Alberto R Yataco | Internal Medicine | 1220a E Joppa Rd, Suite109, Towson, MD 21286-5812 | 2008-10-02 |
| 1063517878 | Neeta S Deshpande | Internal Medicine | 7601 Osler Drive, Towson, MD 21204 | 2006-09-14 |
| 1023084209 | John Loome | Internal Medicine | 515 Fairmount Ave, 9th Floor, Towson, MD 21286-5466 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407409253 | Health Practice Partners LLC | Internal Medicine | 8028 Ritchie Hwy Ste 210b, Pasadena, MD 21122-1059 | 2019-07-22 |
| 1437613163 | Johns Hopkins University | Internal Medicine | 5210 Eastern Avenue, Alpha Center, Baltimore, MD 21224 | 2019-01-28 |
| 1598252371 | Wayne Medical Associate, Inc. | Internal Medicine | 7207 Hanover Pkwy Ste A, Greenbelt, MD 20770-2089 | 2018-04-17 |
| 1649775933 | Old Fashion Medicine, Inc | Internal Medicine | 95 Gatepost Lane, Apartment 1b, Frederick, MD 21701 | 2018-03-28 |
| 1982102943 | 3s Health LLC | Internal Medicine | 10400 Connecticut Ave Ste 206, Kensington, MD 20895-3941 | 2018-01-24 |
| 1225572233 | Pamela Denise Ponder | Internal Medicine | 2603 Portola Court, Odenton, MD 21113 | 2016-12-09 |
| 1912371832 | Phillip W. Stone, Md, LLC | Internal Medicine | 16013 Fields End Ct, Woodbine, MD 21797-7542 | 2015-11-16 |
| 1598023194 | Health First Medical Care LLC | Internal Medicine | 9650 Santiago Rd Ste 6, Columbia, MD 21045-3960 | 2012-05-02 |
| 1609141795 | Mattan Schuchman | Internal Medicine | 5210 Eastern Ave, Alpha Center #127, Baltimore, MD 21224 | 2012-03-21 |
| 1013204171 | Chantal Youssef | Internal Medicine | 13105 Bucks Ridge Ct, Ellicott City, MD 21042 | 2011-07-08 |
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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.