Evernorth Care Providers - Delaware PA
NPI 1063284032ActiveOrganization· General Practice· Baltimore, MD
General Practice in Baltimore, Maryland, registered in NPPES in October 2023. The authorized official on file is Grace Blue, Credentialing Sr. Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1063284032 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 24, 2023 |
| Last updated in NPPES | Mar 18, 2025 |
| Certified by provider | Mar 18, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MD) |
|---|
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