1502 Frederick Road Opco LLC
NPI 1184373250 · Skilled Nursing Facility · Catonsville, MD
Enrolled with Medicare as Part a Provider - Skilled Nursing Facility · source: CMS PECOS Public Provider Enrollment (2026.04.01)
1502 Frederick Road Opco LLC is a Skilled Nursing Facility organization in Catonsville, MD (NPI 1184373250).
Provider details
- NPI number
- 1184373250
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Sam Stern, Cfo(877) 567-0402
Specialties & taxonomies
Nursing & Custodial Care Facilities
- Respite Care385H00000X
Respite Care Facility
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Autumn Lake Healthcare at Summit Park
Registry dates
- Enumerated
- 2022-03-23
- Last updated
- 2022-03-23
- Certified
- 2022-03-23
Frequently asked questions
- What is 1502 Frederick Road Opco LLC's NPI number?
- 1502 Frederick Road Opco LLC's National Provider Identifier (NPI) is 1184373250, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is 1502 Frederick Road Opco LLC?
- 1502 Frederick Road Opco LLC is classified in the NPPES registry as Skilled Nursing Facility (Nursing & Custodial Care Facilities).
- Where is 1502 Frederick Road Opco LLC located?
- 1502 Frederick Road Opco LLC's practice location on file with NPPES is 1502 Frederick Rd, Catonsville, MD 21228-5019.
- What is 1502 Frederick Road Opco LLC's phone number?
- The practice phone number listed in the NPPES registry for 1502 Frederick Road Opco LLC is (410) 747-3287.
- Does 1502 Frederick Road Opco LLC accept Medicare?
- 1502 Frederick Road Opco LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for 1502 Frederick Road Opco LLC?
- The authorized official listed on 1502 Frederick Road Opco LLC's NPPES record is Sam Stern, Cfo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is 1502 Frederick Road Opco LLC's NPI active?
- Yes — 1502 Frederick Road Opco LLC's NPI (1184373250) is active in the NPPES registry as of the last update on 2022-03-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.