Individual provider Active NPI

Dally Alex

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1013548262
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R208579 Issued in MD
Practice address
9000 Franklin Square Dr
Baltimore, MD 21237-3901
Phone
(443) 777-2475
NPI assigned
Jan 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R208579 MD Primary

Addresses

Primary practice location

9000 Franklin Square Dr
Baltimore, MD 21237-3901

Mailing address

14022 Jump Dr
Germantown, MD 20874-6122
Phone (484) 674-5487

Other names 1

  • Dally Alex Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200227001696 DC Practitioner - Nurse Practitioner 8022445279 Reassigns benefits to 2 organizations
I20220818002568 MD Practitioner - Nurse Practitioner 8022445279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLC 3,726 clinicians

Practice addresses (Care Compare)

1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440

4660 Wilkens Ave
Suite 100
Baltimore, MD 21229-4899
Phone (410) 247-0782

9000 Franklin Square Dr
Baltimore, MD 21237-3901
Phone (443) 777-7000

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R208579MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group Anesthesiology LLC CurrentSince Apr 1, 2021 Accepting new patients
Medstar Medical Group II LLC CurrentSince Apr 7, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Apr 6, 2024 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Apr 1, 2021 Accepting new patients
Walter Reed National Military Medical Center Family PastSince Jun 1, 2023 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3007 Tilden St NW
Ste 5N
Washington, DC 20008

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

Organizations & group practices 25

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1013548262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14022 JUMP DR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208746122",
            "telephone_number": "484-674-5487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 FRANKLIN SQUARE DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373901",
            "telephone_number": "443-777-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEX",
        "first_name": "DALLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R208579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DALLY",
            "last_name": "ALEX",
            "credential": "CRNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.