Ac Woundcare LLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

AC WOUNDCARE LLC

Practice address

724 Maiden Choice LN Ste 304
Catonsville, MD 21228-0003

Phone

(718) 362-1411

Fax

(718) 362-1651

NPI assigned

Oct 15, 2025

Last updated

Oct 15, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Atemkeng Fomengia, PANPI 1700332996

Title

Owner

Phone

(718) 362-1411

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Atemkeng Fomengia

  • Medical Physician Assistant
  • Catonsville, MD
  • NPI 1700332996
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1003782137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 CORPORATE WAY STE 2M",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892027",
            "telephone_number": "718-362-1411",
            "fax_number": "718-362-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 MAIDEN CHOICE LN STE 304",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212280003",
            "telephone_number": "718-362-1411",
            "fax_number": "718-362-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AC WOUNDCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A",
        "authorized_official_last_name": "FOMENGIA",
        "authorized_official_first_name": "ATEMKENG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-362-1411",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.