ACG MD ENT LLC — NPI 1396288916 (Licensed & Credentialed Allopathic & Osteopathic Physicians

CMS-1500 Box 24J / 33a • NPI

1396288916

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207Y00000X (CMS 04)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Otolaryngology

Box 32 Service Location & ZIP+4

6565 N CHARLES ST, SUITE 315, TOWSON, MD, 21204-6800

✓ 9-Digit EDI 837 ZIP+4 (21204-6800)

Practice Phone & Referral Fax

(410) 215-2510

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1396288916 (ACG MD ENT LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1396288916` (NPI-2 Organization / Facility)
Provider / Legal Name	ACG MD ENT LLC
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Otolaryngology NUCC Code: `207Y00000X` (Otolaryngology)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	6565 N CHARLES ST, SUITE 315, TOWSON, MD, 21204-6800
Practice Telephone / Fax	Tel: (410) 215-2510
Administrative Mailing Address	6565 N CHARLES ST, TOWSON, MD, 21204-6800
Enumeration & Last Sync	Enumerated: 2016-11-30 \| CMS Record Updated: 2017-01-10
Authorized Official	ANDREW GOLDSTONE (Physician/Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

6565 N CHARLES ST, SUITE 315, TOWSON, MD, 21204-6800

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Plain-English Taxonomy & CMS Crosswalk (207Y00000X)

What Does Taxonomy Code 207Y00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207Y00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Otolaryngology"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 04 (Physician/Otolaryngology)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Otolaryngology for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ACG MD ENT LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207Y00000X` — Otolaryngology Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Otolaryngology	State: MD \| License: `D39723` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ACG MD ENT LLC (NPI #1396288916)