LIFEBRIDGE COMMUNITY PEDIATRICS, LLC
NPI 1629495528
Pediatrics in Towson, MD
About Lifebridge Community Pediatrics, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LIFEBRIDGE COMMUNITY PEDIATRICS, LLC (NPI 1629495528), doing business as Main Street Pediatrics, is a healthcare organization registered as a pediatrics in Towson, Maryland and active in the NPI registry since March 2014. The organization lists Mary Wright-sisk, Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lifebridge Community Pediatrics, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
16Medicare enrollment records show 16 clinicians reassign Medicare billing to Lifebridge Community Pediatrics, LLC, which bills Medicare for the services they deliver. Of these, 7 practice at this address and 14 within 10 miles. They are listed nearest first.
Clinicians, nearest first (16)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Lifebridge Community Pediatrics, LLC's NPI number?
The NPI number for Lifebridge Community Pediatrics, LLC is 1629495528. It was assigned to this organization in the NPPES registry on March 28, 2014. The provider is doing business as Main Street Pediatrics.
Where is Lifebridge Community Pediatrics, LLC located?
Lifebridge Community Pediatrics, LLC is located at 849 Fairmount Ave Ste 100A Main Street Pediatrics, Towson, MD 21286. The listed phone number is (410) 494-1369.
What is Lifebridge Community Pediatrics, LLC's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Lifebridge Community Pediatrics, LLC enrolled in Medicare?
Yes. Lifebridge Community Pediatrics, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lifebridge Community Pediatrics, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 16 clinicians, all in Pediatric Medicine, reassign their Medicare billing to Lifebridge Community Pediatrics, 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. Of these, 7 practice at this address and 14 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Lifebridge Community Pediatrics, LLC was last updated on October 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days 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.
# Lifebridge Community Pediatrics, Llc · NPI 1629495528
Pediatrics organization in Towson, Maryland. Organization record, active in the CMS NPPES registry since March 28, 2014.
## Identity
- **NPI:** 1629495528 (Entity type: Organization)
- **Enumerated:** March 28, 2014
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **Also known as:** Main Street Pediatrics (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Mary Wright-Sisk, DIRECTOR
## Practice location
- **Address:** 849 FAIRMOUNT AVE STE 100A, MAIN STREET PEDIATRICS, Towson, MD 21286-2600
- **Phone:** (410) 494-1369 · **Fax:** (410) 494-2737
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 16 clinicians (Pediatric Medicine) reassign Medicare billing to this organization (form CMS-855R); 7 practice at this address and 14 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 23, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1629495528) · Data from the CMS NPPES public registry.