DR. STEPHEN JOHN WITANOWSKI (MD) – Internal Medicine Physician, NPI 1003040726

DR. STEPHEN JOHN WITANOWSKI (MD) is a healthcare provider. based in Baltimore, Maryland. specializing in Internal Medicine Physician. They hold the professional credentials MD. They hold a License No. D0080458 (MD). The NPI Number for DR. STEPHEN JOHN WITANOWSKI (MD) is 1003040726

Main info

Male
Sole Proprietor
45 Years Of Experience
Accepts Medicare Assignment
Name
DR. STEPHEN JOHN WITANOWSKI (MD)
NPI
1003040726
Phone
(410) 469-5544
Address
2700 QUARRY LAKE DR
Enumeration Date
9 May 2009
Last Update Date
25 January 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1981 (45 years ago)
PAC ID
7113051186
Group Practice PAC ID
3678751468
Professional Enrollment ID
I20160208000078
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

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Provider Addresses for DR. STEPHEN JOHN WITANOWSKI (MD)

  • The Lifebridge Health Pavilion, 2700, Quarry Lake Drive, Helmsley Court, Pikesville, Baltimore County, Maryland, 21209, United States

    SUITE 280

    BALTIMORE, MD 212093742

    Phone: (410) 469-5544

    Fax: (410) 585-2867

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-02-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160208000078IInternal MedicineMDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 21209)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3678751468View full group profile
NameSpecialtyState
-CA
Diagnostic RadiologyVA
Diagnostic Radiology, Interventional RadiologyOH
-MD
Diagnostic RadiologyMD
-MD
Nuclear Medicine, Diagnostic RadiologyOH
Physician AssistantMD
Internal MedicineVA
Nurse PractitionerMD

Reviews

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Frequently asked questions

How do I look up DR. STEPHEN JOHN WITANOWSKI (MD) by NPI?
Use NPI 1003040726 when you need to reference DR. STEPHEN JOHN WITANOWSKI (MD) in forms, claims, or directories.
Is DR. STEPHEN JOHN WITANOWSKI (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does DR. STEPHEN JOHN WITANOWSKI (MD) work in?
You can think of DR. STEPHEN JOHN WITANOWSKI (MD) as practicing within Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is DR. STEPHEN JOHN WITANOWSKI (MD)'s primary listing?
We display Baltimore, Maryland because that is what the record indicates for DR. STEPHEN JOHN WITANOWSKI (MD).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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