Anticoagulation Management Services
Anticoagulation Clinic at Johns Hopkins Bayview Medical Center
The anticoagulation clinic is a pharmacist-managed outpatient clinic that provides specialized anticoagulation medication management to patients at risk for blood clots, focusing on the blood thinner warfarin (Coumadin®). Patients at risk for blood clots include those with a history of heart disease, atrial fibrillation, deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke and other diseases.
The clinic's goal is to provide patients with highly individualized, ongoing monitoring of their warfarin anticoagulant therapy to decrease the risk of adverse events. Services include routine point-of-care blood test monitoring to check patients’ INR (International Normalized Ratio), in an effort to properly dose adjust drug therapy. This finger-stick test allows the staff to obtain immediate results and make necessary adjustments to patients’ medication dosage during their visits.
Additionally, the pharmacists provide counseling and education to patients about food and drug interactions, potential adverse drug reactions and appropriate medication use.
Making An Appointment
Appointments are available Monday through Thursday, 8 a.m. to 3:30 p.m. and Friday, 8 a.m. to 12 p.m. After receiving a referral from your physician, you can make an appointment by calling 410-550-7088 or using the general appointment line at 410-614-4525.
JHBMC Anticoagulation Clinic
4940 Eastern Avenue
A Building, 1st Floor
Baltimore, MD 21224-2780
Patient Information
What to Bring and Expect
To aid us in determining your warfarin regimen, please bring a list of your current medications, including any vitamins and supplements. Additionally, please bring your insurance card for billing purposes. In order to best monitor your warfarin, we will need to gather information regarding any prescription and over the counter medicines that you take, and update this list at every visit. We will also need to know about your typical diet, so we can plan a consistent diet regimen and adjust your warfarin therapy accordingly.
Every appointment includes a comprehensive assessment of any bleeding or clotting symptoms. The first visit typically takes 30 minutes to 1 hour, and you will be provided with an introductory patient education packet. Subsequent visits are scheduled for 20 minutes.
Billing and Insurance
Many health insurance plans will pay for anticoagulation treatment at our outpatient clinic. Your coverage will be based upon your specific insurance plan.
Making An Appointment
Appointments are available Monday through Thursday, 8 a.m. to 3:30 p.m. and Friday, 8 a.m. to 12 p.m. After receiving a referral from your physician, you can make an appointment by calling 410-550-7088 or using the general appointment line at 410-614-4525.
JHBMC Anticoagulation Clinic
4940 Eastern Avenue
A Building, 1st Floor
Baltimore, MD 21224-2780
Patient Resources
Referral Form: A referral is required from your health care provider to utilize this outpatient service.
Warfarin Patient Guide (English)
Warfarin Patient Guide (Spanish)
Medical Director
Pharmacists
Charlie Twilley, PharmD, MBA
Clinical Pharmacy Specialist
Dr. Charlie Twilley is a clinical pharmacy specialist in ambulatory medicine/anticoagulation management. He earned a doctorate of pharmacy from the University of Maryland and an MBA at the University of Baltimore. He has worked at the Johns Hopkins Bayview Medical Center for over 25 years. In addition to serving as a clinical assistant professor at the University of Maryland and precepting students from the College of Notre Dame in Maryland, Dr. Twilley also precepts ambulatory care medicine and drug information & policy for the PGY-1 Residency Program at Johns Hopkins Bayview Medical Center.
Dr. Charlie Twilley is a clinical pharmacy specialist in ambulatory medicine/anticoagulation management. He earned a doctorate of pharmacy from the University of Maryland and an MBA at the University of Baltimore. He has worked at the Johns Hopkins Bayview Medical Center for over 25 years. In addition to serving as a clinical assistant professor at the University of Maryland and precepting students from the College of Notre Dame in Maryland, Dr. Twilley also precepts ambulatory care medicine and drug information & policy for the PGY-1 Residency Program at Johns Hopkins Bayview Medical Center.
Nazeer Ahmed, PharmD, BCPS, CGP
Clinical Pharmacy Specialist
Dr. Nazeer Ahmed graduated from University of Madras, India with a bachelors in pharmacy. He later earned a doctorate of pharmacy degree at the University of Maryland, Baltimore School of Pharmacy. He is board-certified in pharmacotherapy and is a certified geriatric pharmacist.
Dr. Ahmed is a clinical specialist in internal medicine and geriatrics at Johns Hopkins Bayview Medical Center.
Dr. Ahmed is a member of both ASHP and MSHP and plays an active role in educating and mentoring both student pharmacists and PGY1 residents on his internal medicine rotation. He is highly recognized by his internal medicine faculty and nurses and is involved with various committees focused on improving the health and safety of medicine and geriatric patients. Dr. Ahmed has received recognition from the Medical Center for his many contributions to safe patient care.
Dr. Nazeer Ahmed graduated from University of Madras, India with a bachelors in pharmacy. He later earned a doctorate of pharmacy degree at the University of Maryland, Baltimore School of Pharmacy. He is board-certified in pharmacotherapy and is a certified geriatric pharmacist.
Dr. Ahmed is a clinical specialist in internal medicine and geriatrics at Johns Hopkins Bayview Medical Center.
Dr. Ahmed is a member of both ASHP and MSHP and plays an active role in educating and mentoring both student pharmacists and PGY1 residents on his internal medicine rotation. He is highly recognized by his internal medicine faculty and nurses and is involved with various committees focused on improving the health and safety of medicine and geriatric patients. Dr. Ahmed has received recognition from the Medical Center for his many contributions to safe patient care.
Ronak Amin, PharmD
Pharmacist
Dr. Amin earned his doctorate of pharmacy degree from The Ernest Mario School of Pharmacy at Rutgers University. He joined Johns Hopkins Bayview Medical Center as a pharmacist in 2020. He has a wide range of interests within the pharmacy department and provides patient care in the oncology infusion center, OR satellite, and in-patient pharmacy. Dr. Amin is involved in various committees and projects within the department helping improve workflow and communication.
Dr. Amin earned his doctorate of pharmacy degree from The Ernest Mario School of Pharmacy at Rutgers University. He joined Johns Hopkins Bayview Medical Center as a pharmacist in 2020. He has a wide range of interests within the pharmacy department and provides patient care in the oncology infusion center, OR satellite, and in-patient pharmacy. Dr. Amin is involved in various committees and projects within the department helping improve workflow and communication.
Nicholas DeFreitas, PharmD
Dr. Nicholas DeFreitas earned his doctorate of pharmacy from the University of Maryland School of Pharmacy in Baltimore, Maryland in 2022. He joined Johns Hopkins Bayview Medical Center as a pharmacist shortly after graduation in 2022. Dr. DeFreitas’ interests include practicing in the anticoagulation clinic, precepting pharmacy students, and inpatient pharmacy service.
Oshrah Golfeiz, PharmD
Pharmacist
Dr. Oshrah Golfeiz earned a doctorate of pharmacy degree from the University of Maryland School of Pharmacy in 2018. She joined Johns Hopkins Bayview Medical Center shortly thereafter and currently practices in the oncology infusion center, anticoagulation clinic and inpatient pharmacy. Besides providing patient care, Dr. Golfeiz is also involved in interdisciplinary projects measuring nursing satisfaction and targeting medication optimization.
Dr. Oshrah Golfeiz earned a doctorate of pharmacy degree from the University of Maryland School of Pharmacy in 2018. She joined Johns Hopkins Bayview Medical Center shortly thereafter and currently practices in the oncology infusion center, anticoagulation clinic and inpatient pharmacy. Besides providing patient care, Dr. Golfeiz is also involved in interdisciplinary projects measuring nursing satisfaction and targeting medication optimization.
Adwoa Nyame, PharmD, BCPS
Clinical Pharmacist
Dr. Adwoa Nyame is a clinical pharmacist in oncology, smoking cessation and anticoagulation. She earned her Doctor of Pharmacy degree from Virginia Commonwealth University School of Pharmacy. She then went on to complete her PGY-1 Pharmacy Practice Residency at Johns Hopkins Bayview Medical Center.
She is currently the clinic lead for the JHBMC Sidney Kimmel Comprehensive Cancer Center smoking cessation clinic. She also precepts the ambulatory care rotation experience for the PGY-1 Residency Program at Johns Hopkins Bayview Medical Center. Additionally, she is an active member of the American College of Clinical Pharmacy (ACCP). Her professional interests include oncology, academia and public health.
Dr. Adwoa Nyame is a clinical pharmacist in oncology, smoking cessation and anticoagulation. She earned her Doctor of Pharmacy degree from Virginia Commonwealth University School of Pharmacy. She then went on to complete her PGY-1 Pharmacy Practice Residency at Johns Hopkins Bayview Medical Center.
She is currently the clinic lead for the JHBMC Sidney Kimmel Comprehensive Cancer Center smoking cessation clinic. She also precepts the ambulatory care rotation experience for the PGY-1 Residency Program at Johns Hopkins Bayview Medical Center. Additionally, she is an active member of the American College of Clinical Pharmacy (ACCP). Her professional interests include oncology, academia and public health.
Paul Ortiz, PharmD, BCPS, CGP
Clinical Pharmacy Specialist
Dr. Ortiz is a clinical pharmacy specialist in internal medicine and geriatrics at Johns Hopkins Bayview Medical Center. He earned a doctorate of pharmacy from the University of Maryland School of Pharmacy. After graduation, he completed a PGY-1 Pharmacy Practice Residency at Johns Hopkins Bayview Medical Center and a PGY-2 Geriatric Pharmacy Practice Residency at the University of Maryland School of Pharmacy.
Dr. Ortiz is involved in various committees within the institution, including Medication Error Reduction Improvement Team (MERIT) and the Falls & Restraints Committee. He also is an active member of Maryland Chapter of American Society of Consultant Pharmacists (MD-ASCP). His clinical interests include geriatrics, transitions of care, dementia and medication safety.
Dr. Ortiz is a clinical pharmacy specialist in internal medicine and geriatrics at Johns Hopkins Bayview Medical Center. He earned a doctorate of pharmacy from the University of Maryland School of Pharmacy. After graduation, he completed a PGY-1 Pharmacy Practice Residency at Johns Hopkins Bayview Medical Center and a PGY-2 Geriatric Pharmacy Practice Residency at the University of Maryland School of Pharmacy.
Dr. Ortiz is involved in various committees within the institution, including Medication Error Reduction Improvement Team (MERIT) and the Falls & Restraints Committee. He also is an active member of Maryland Chapter of American Society of Consultant Pharmacists (MD-ASCP). His clinical interests include geriatrics, transitions of care, dementia and medication safety.
Navya Varshney, PharmD, BCPS
Clinical Pharmacy Specialist
Dr. Varshney is a clinical pharmacy specialist in internal medicine, geriatrics, and ambulatory care. She is the Student Coordinator and serves as a preceptor for the University of Maryland, Shenandoah University, and Notre Dame of Maryland University. She is also the Co-Chair of the Diabetes subcommittee of the Johns Hopkins Pharmacy Clinical Practice Council and serves as the P&T Secretary.
She earned a doctorate of pharmacy degree from the University of Michigan College of Pharmacy. After graduation, she completed a PGY-1 pharmacy residency at the University of California, San Francisco and PGY-2 residency in ambulatory care and family medicine at the University of Colorado. Her interests include cardiology, endocrinology, geriatrics, leadership, and population health.
Dr. Varshney is a clinical pharmacy specialist in internal medicine, geriatrics, and ambulatory care. She is the Student Coordinator and serves as a preceptor for the University of Maryland, Shenandoah University, and Notre Dame of Maryland University. She is also the Co-Chair of the Diabetes subcommittee of the Johns Hopkins Pharmacy Clinical Practice Council and serves as the P&T Secretary.
She earned a doctorate of pharmacy degree from the University of Michigan College of Pharmacy. After graduation, she completed a PGY-1 pharmacy residency at the University of California, San Francisco and PGY-2 residency in ambulatory care and family medicine at the University of Colorado. Her interests include cardiology, endocrinology, geriatrics, leadership, and population health.
Clinic Staff
Lynn Grammer
Patient Registrar
Lynn Grammer has 29 years of experience with the Hopkins System, including five years in the finance area and 24 years working as a patient registrar. She enjoys working with the patients, staff, and families and does her best to accommodate their needs. Working as a patient registrar has helped her to understand the different cultures of patients at JHBMC, which is an important part in caring for people.
Lynn Grammer has 29 years of experience with the Hopkins System, including five years in the finance area and 24 years working as a patient registrar. She enjoys working with the patients, staff, and families and does her best to accommodate their needs. Working as a patient registrar has helped her to understand the different cultures of patients at JHBMC, which is an important part in caring for people.
Holly McDaniel, MSN, RN
Ambulatory Services Manager II
