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STACIE B PEDDY M.D. NPI 1700805090


NPI Information

NPI: 1700805090
Provider Name: STACIE B PEDDY, M.D.
Classification: Pediatrics - 2080P0203X
Entity Type: Individual

Specialization: Pediatric Critical Care Medicine

PECOS Registration: Yes

Address:
22 S GREENE ST
BALTIMORE, MD
ZIP 21201
Phone: (410) 328-6957
Get Directions

Stacie B Peddy, M.D. is a pediatric critical care medicine pediatrics in Baltimore, MD. The provider is a pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. Stacie B Peddy, M.D. NPI is 1700805090. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

22 S GREENE ST
BALTIMORE, MD
ZIP 21201-544
Phone: (410) 328-6957
Fax: (410) 706-5103

The NPI 1700805090 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/18/2006 and was last updated on 10/19/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsMD426570PENNSYLVANIANo
22080P0202XPediatricsPediatric CardiologyMD426570PENNSYLVANIANo
32080P0203XPediatricsPediatric Critical Care MedicineMD426570PENNSYLVANIANo
42080P0203XPediatricsPediatric Critical Care MedicineD92544MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10092967MEDICAIDNEW JERSEY
2101470283MEDICAIDPENNSYLVANIA
3242289EMDOTHERPENNSYLVANIAMEDICARE PTAN
4659065900MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.