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MEDSPA M.D. LLC
NPI 1871848614
General Practice in Baltimore, MD

Active since July 18, 2012
1804 W NORTH AVE, BALTIMORE, MD 21217(410) 685-6331(410) 685-6332 Get Directions Write a Review

NPPES record last updated: December 10, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Medspa M.d. Llc NPPES

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

MEDSPA M.D. LLC (NPI 1871848614) is a healthcare organization registered as a general practice in Baltimore, Maryland and active in the NPI registry since July 2012. The organization lists Susan Renee Clanzy, Ceo, as its authorized official.

NPPES Registry Identity

NPI1871848614
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameMEDSPA M.D. LLC
Location Address1804 W NORTH AVEBaltimore, MD 21217-1621
Mailing Address1804 W North AveBaltimore, MD 21217-1621 · (410) 685-6331 · Fax (410) 685-6332
Phone(410) 685-6331
Fax(410) 685-6332
Organization SubpartNo
Authorized OfficialSusan Renee ClanzyCeo · (410) 446-2257
Enumeration DateJuly 18, 2012
Last NPPES UpdateDecember 10, 2025
NPPES CertifiedDecember 10, 2025
✔ NPI 1871848614 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in MD · D0060902
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
1804 W NORTH AVE, Baltimore, MD 21217
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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 and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Medspa M.d. Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Medspa M.D. LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Susan Clanzy, M.D.
General Practice
NPI 1568435634
1804 W NORTH AVE
Baltimore, MD 21217
(410) 685-6331
✔ PECOSSame address

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 Medspa M.D. LLC's NPI number?

The NPI number for Medspa M.D. LLC is 1871848614. It was assigned to this organization in the NPPES registry on July 18, 2012.

Where is Medspa M.D. LLC located?

Medspa M.D. LLC is located at 1804 W North Ave, Baltimore, MD 21217. The listed phone number is (410) 685-6331.

What is Medspa M.D. LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Medspa M.D. LLC enrolled in Medicare?

Yes. Medspa M.D. LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Medspa M.D. LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (General Practice) reassigns their Medicare billing to Medspa M.D. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Medspa M.D. LLC was last updated on December 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.