DR. MARGARET A BAUMGARTEN M.D.
NPI 1023096559
Family Medicine in Portsmouth, VA

Active since January 05, 2006PECOS EnrolledAccepts Medicare Assignment
95.11/100
CMS Quality Rating
3640 HIGH ST STE 3B, PORTSMOUTH, VA 23707(757) 397-6344(757) 606-1185 Get Directions Write a Review

NPPES record last updated: March 19, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Margaret A Baumgarten M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARGARET A BAUMGARTEN M.D. (NPI 1023096559) is an individual family medicine provider in Portsmouth, Virginia, licensed in Virginia (0101231807) and active in the NPI registry since January 2006. She is enrolled in Medicare PECOS, is affiliated with Sentara Norfolk General Hospital, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1023096559
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MARGARET A BAUMGARTENCredential: M.D.
Location Address3640 HIGH ST STE 3BPortsmouth, VA 23707-3213
Mailing AddressPo Box 936Norfolk, VA 23501-0936 · (757) 397-6344 · Fax (757) 606-1185
Fax(757) 606-1185
Sole ProprietorNo
Medical School CMSOtherGraduated 1992
Enumeration DateJanuary 5, 2006
Last NPPES UpdateMarch 19, 2018
NPI 1023096559 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in VA · 0101231807
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

3640 HIGH ST STE 3B, Portsmouth, VA 23707

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Margaret A Baumgarten M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002820560
PECOS Enrollment IDI20060203000450
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
47 services20 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
32 services24 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
12 services12 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
11 services11 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sentara Norfolk General Hospital

Acute Care Hospitals · Norfolk, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number490007
Location600 Gresham DrNorfolk, VA 23507 · Norfolk City County
Emergency services Birthing friendly

Bon Secours Maryview Medical Center

Acute Care Hospitals · Portsmouth, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490017
Location3636 High StreetPortsmouth, VA 23707 · Portsmouth City County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23707 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.11/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.31
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630
DME-Other DME · category DE000N
1 supplier12 claims12 services$38.16 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Student in an Organized Health Care Education/Training Program
3640 HIGH ST STE 3B
PORTSMOUTH, VA 23707
Family Medicine
3640 HIGH ST STE 3B
PORTSMOUTH, VA 23707
Family Medicine
3640 HIGH ST STE 3B
PORTSMOUTH, VA 23707
Family Medicine
3640 HIGH ST STE 3B
PORTSMOUTH, VA 23707
Family Medicine
3640 HIGH ST STE 3B
PORTSMOUTH, VA 23707
Family Medicine
3640 HIGH ST STE 3B
PORTSMOUTH, VA 23707
Family Medicine
3640 HIGH ST STE 3B
PORTSMOUTH, VA 23707
Student in an Organized Health Care Education/Training Program
3640 HIGH ST STE 3B
PORTSMOUTH, VA 23707

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Margaret Baumgarten's NPI number?

The NPI number for Margaret Baumgarten is 1023096559. It was assigned to this individual provider in the NPPES registry on January 5, 2006.

Where is Margaret Baumgarten located?

Margaret Baumgarten practices at 3640 High St Ste 3B, Portsmouth, VA 23707. The listed phone number is (757) 397-6344.

What is Margaret Baumgarten's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Margaret Baumgarten enrolled in Medicare?

Yes. Margaret Baumgarten is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Margaret Baumgarten affiliated with any hospitals?

According to CMS data, Margaret Baumgarten is affiliated with Sentara Norfolk General Hospital and Bon Secours Maryview Medical Center.

When was this NPI record last updated?

The NPPES record for Margaret Baumgarten was last updated on March 19, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.