BAYSIDE PRIMARY CARE LLC
NPI 1093834830
Specialist in Prince Frederick, MD

Active since March 29, 2007CLIA 21D1051159 · Microscopy
301 STEEPLE CHASE DR, STE 103, PRINCE FREDERICK, MD 20678(410) 414-5633(410) 414-5911 Get Directions Write a Review

NPPES record last updated: May 27, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Bayside Primary Care Llc NPPES

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

BAYSIDE PRIMARY CARE LLC (NPI 1093834830) is a healthcare organization registered as a specialist in Prince Frederick, Maryland and active in the NPI registry since March 2007. The organization holds a CLIA Microscopy certificate valid through February 22, 2028 and lists Deborah R Brower, Owner, as its authorized official.

NPPES Registry Identity

NPI1093834830
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameBAYSIDE PRIMARY CARE LLC
Location Address301 STEEPLE CHASE DR, STE 103Prince Frederick, MD 20678-4049
Mailing Address301 Steeple Chase Dr, Ste 103Prince Frederick, MD 20678-4049 · (410) 414-5633 · Fax (410) 414-5911
Fax(410) 414-5911
Organization SubpartNo
Authorized OfficialDeborah R BrowerOwner · (410) 414-5633
Enumeration DateMarch 29, 2007
Last NPPES UpdateMay 27, 2014
✔ NPI 1093834830 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in MD · R126934
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
301 STEEPLE CHASE DR, Prince Frederick, MD 20678

Other Identifiers 2

Medicaid410114600MD
Medicare UPINP59831MD

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bayside Primary Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMarylandEnrollment IDO20060501000587Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Bayside Primary Care LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Nurse Practitioner
NPI 1225011992
489 MAIN ST SUITE 102
Prince Frederick, MD 20678
(410) 414-5633
✔ PECOS✔ Accepts Medicare1.1 mi
Family Practice
NPI 1750321220
23000 MOAKLEY ST
Leonardtown, MD 20650
(240) 744-1100
✔ PECOS17 mi
Nurse Practitioner
NPI 1316348915
3261 OLD WASHINGTON RD
Waldorf, MD 20602
(301) 653-2136
✔ PECOS✔ Accepts Medicare18 mi
Nurse Practitioner
NPI 1205329257
5900 WATERLOO RD STE 200
Columbia, MD 21045
(410) 740-2900
✔ PECOS✔ Accepts Medicare47 mi
Nurse Practitioner
NPI 1275189862
330 N HOWARD ST
Baltimore, MD 21201
(410) 576-1414
✔ PECOS✔ Accepts Medicare51 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 21D1051159

Bayside Primary Care · Prince Frederick, MD
Active · expires Feb 22, 2028
CLIA Number21D1051159
Laboratory TypePhysician Office
Certificate Effective DateFebruary 23, 2026
Certificate Expiration DateFebruary 22, 2028
Laboratory DirectorDeborah R. Brower
Laboratory Phone(410) 414-5633
Laboratory LocationBayside Primary Care489 Main St Ste 102, Prince Frederick, MD 20678
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Bayside Primary Care LLC's NPI number?

The NPI number for Bayside Primary Care LLC is 1093834830. It was assigned to this organization in the NPPES registry on March 29, 2007.

Where is Bayside Primary Care LLC located?

Bayside Primary Care LLC is located at 301 Steeple Chase Dr Ste 103, Prince Frederick, MD 20678. The listed phone number is (410) 414-5633.

What is Bayside Primary Care LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Bayside Primary Care LLC enrolled in Medicare?

Yes. Bayside Primary Care LLC is registered in the Medicare PECOS enrollment system.

When is Bayside Primary Care LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Maryland, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Bayside Primary Care LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Bayside Primary Care LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (4) and Family Practice (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Bayside Primary Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 21D1051159) is associated with this NPI, valid through February 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bayside Primary Care LLC was last updated on May 27, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.