MAIN STREET PEDIATRICS, L.L.C.
NPI 1174645428
Pediatrics in Towson, MD

Active since April 06, 2007CLIA 21D0684816 · Waiver
515 FAIRMOUNT AVE, SUITE 200, TOWSON, MD 21286(410) 494-1369 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 22, 2020, Jun 21, 2018 (2 updates tracked since 2018).

About Main Street Pediatrics, L.l.c. NPPES

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

MAIN STREET PEDIATRICS, L.L.C. (NPI 1174645428) is a healthcare organization registered as a pediatrics in Towson, Maryland and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through September 30, 2027 and lists Jody Levison, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1174645428
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameMAIN STREET PEDIATRICS, L.L.C.
Location Address515 FAIRMOUNT AVE, SUITE 200Towson, MD 21286-5466
Mailing Address515 Fairmount Ave, Suite 200Towson, MD 21286-5466 · (410) 494-1369
Organization SubpartNo
Authorized OfficialJody LevisonOffice Manager · (410) 494-2799
Enumeration DateApril 6, 2007
Last NPPES UpdateAugust 22, 20202 updates tracked since enumeration
NPI 1174645428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

515 FAIRMOUNT AVE, Towson, MD 21286

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

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 of Waiver 21D0684816

Lifebridge Comm Pediatrics Dba Main St Pediatrics · Towson, MD
Active · expires Sep 30, 2027
CLIA Number21D0684816
Laboratory TypePhysician Office
Certificate Effective DateOctober 1, 2025
Certificate Expiration DateSeptember 30, 2027
Laboratory DirectorDr. Deborah G. Bittar
Laboratory Phone(410) 494-1369
Laboratory LocationLifebridge Comm Pediatrics Dba Main St Pediatrics849 Fairmount Ave Suite 100A, Towson, MD 21286
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

Internal Medicine (Cardiovascular Disease)
515 FAIRMOUNT AVE, STE 400
TOWSON, MD 21286
Internal Medicine (Geriatric Medicine)
515 FAIRMOUNT AVE, 9TH FLOOR
TOWSON, MD 21286
Pediatrics
515 FAIRMOUNT AVE, SUITE 200
TOWSON, MD 21286
Community/Behavioral Health
515 FAIRMOUNT AVE, 8TH FLOOR
TOWSON, MD 21286
Psychiatry & Neurology (Psychiatry)
515 FAIRMOUNT AVE, SUITE 402
TOWSON, MD 21286
Surgery
515 FAIRMOUNT AVE, STE 210
TOWSON, MD 21286
Physical Therapist
515 FAIRMOUNT AVE, SUITE 530
TOWSON, MD 21286
Internal Medicine (Geriatric Medicine)
515 FAIRMOUNT AVE
TOWSON, MD 21286

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 Main Street Pediatrics, L.L.C.'s NPI number?

The NPI number for Main Street Pediatrics, L.L.C. is 1174645428. It was assigned to this organization in the NPPES registry on April 6, 2007.

Where is Main Street Pediatrics, L.L.C. located?

Main Street Pediatrics, L.L.C. is located at 515 Fairmount Ave Suite 200, Towson, MD 21286. The listed phone number is (410) 494-1369.

What is Main Street Pediatrics, L.L.C.'s specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Main Street Pediatrics, L.L.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D0684816) is associated with this NPI, valid through September 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Main Street Pediatrics, L.L.C. was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.