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NPI 1487488490 · Gerontology Nurse Practitioner · Baltimore, MD

Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)

Provider details

NPI number: 1487488490
Entity type: Individual
Primary specialty: Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Sex: Male
Sole proprietor: No
License: 80884 (NM)

Specialties & taxonomies

Gerontology Nurse PractitionerPrimary363LG0600XLicense 80884 (NM)
Physician Assistants & Advanced Practice Nursing Providers

Profile Score

Basic profile(43/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure28% of score
1 yr in NPPES registry
Profile completeness28% of score
100% of core fields populated
Practice footprint17% of score
1 documented practice location
Medicare service volume (vs. specialty peers)28% of score
125 Medicare services, 2024 (ranked within specialty)

Medicare volume is ranked against active providers in the same specialty. 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.

What this provider does (Medicare)

Based on Medicare fee-for-service claims, 2024; not all care is captured.

Service (HCPCS)	Medicare services	Typical Medicare-allowed (2024)
Subsequent Nursing Facility Care With Moderate Level of Medical Decision Making, Per Day, If Using Time, at Least 30 Minutes99309	79	$87
Subsequent Nursing Facility Care With Straightforward Level of Medical Decision Making, Per Day, If Using Time, 20 Minutes Or More99308	32	$60
Nursing Facility Discharge Management, More Than 30 Minutes99316	14	$106

Typical Medicare-allowed amounts for these services range $60–$106 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.

What this provider prescribes (Medicare Part D)

Top drugs by Medicare Part D claim volume, 2024 · 2 distinct drugs on file.

Drug	Part D claims (2024)	Beneficiaries
Oseltamivir Phosphate	38	31
Oxycodone Hcl	11	—

Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.

Practice location

624 Archer St

Baltimore, MD 21230-2516

Phone: (443) 803-2460

Street-level locationGet directions

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Mailing address