LIFEBRIDGE COMMUNITY PEDIATRICS LLC MAIN STREET PEDIATRICS
NPI 1790129054
Pediatrics in Towson, MD
About Lifebridge Community Pediatrics Llc Main Street Pediatrics NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LIFEBRIDGE COMMUNITY PEDIATRICS LLC MAIN STREET PEDIATRICS (NPI 1790129054) is a healthcare organization registered as a pediatrics in Towson, Maryland and active in the NPI registry since April 2013. The organization lists Mary R Wright-sisk, Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 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 Main Street Pediatrics is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
316Medicare enrollment records show 316 clinicians reassign Medicare billing to Lifebridge Community Pediatrics LLC Main Street Pediatrics, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 115 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 24
Nearest to this location (20)
See all 316Source: 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 Physicians, Inc's NPI number?
The NPI number for Lifebridge Community Physicians, Inc is 1790129054. It was assigned to this organization in the NPPES registry on April 17, 2013. The provider is doing business as Lifebridge Community Pediatrics LLC Main Street Pediatrics.
Where is Lifebridge Community Physicians, Inc located?
Lifebridge Community Physicians, Inc is located at 515 Fairmount Ave Suite 200, Towson, MD 21286. The listed phone number is (410) 494-1369.
What is Lifebridge Community Physicians, Inc's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Lifebridge Community Physicians, Inc enrolled in Medicare?
Yes. Lifebridge Community Physicians, Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lifebridge Community Physicians, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 316 clinicians in 24 Medicare specialties reassign their Medicare billing to Lifebridge Community Physicians, Inc. 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 (88), Internal Medicine (53) and Diagnostic Radiology (52). Of these, 1 practice at this address and 115 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 Physicians, Inc was last updated on August 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Lifebridge Community Pediatrics Llc Main Street Pediatrics · NPI 1790129054
Pediatrics organization in Towson, Maryland. Organization record, active in the CMS NPPES registry since April 17, 2013.
## Identity
- **NPI:** 1790129054 (Entity type: Organization)
- **Enumerated:** April 17, 2013
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **Legal business name:** Lifebridge Community Physicians, Inc
- **Organization subpart:** No
- **Authorized official:** Mary Wright-Sisk, DIRECTOR
## Practice location
- **Address:** 515 FAIRMOUNT AVE, SUITE 200, Towson, MD 21286-5466
- **Phone:** (410) 494-1369 · **Fax:** (410) 494-2737
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 316 clinicians in 24 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (88), Internal Medicine (53), Diagnostic Radiology (52); 1 practice at this address and 115 within 10 miles; [full list](https://npiprofile.com/npi/1790129054/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 27, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1790129054) · Data from the CMS NPPES public registry.