Active NPI
Aglae Economides, MD
- Pediatrics Physician
- Rockville, MD
National Provider Identifier
1023002235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 10794
- Practice address
- 6000 Executive Blvd
Suite 625
Rockville, MD 20852-3803 - Phone
- (240) 314-7080
- NPI assigned
- Sep 1, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 10794 | TN | Primary |
Addresses
Primary practice location
6000 Executive Blvd
Suite 625
Rockville, MD 20852-3803
Mailing address
3100 Wyman Park Dr
Ste 200
Baltimore, MD 21211-2803
Phone (410) 338-3500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3194209 | Medicaid | TN | |
| 376751500 | Medicaid | MD |
Other names 1
- Dr. Aglae Koumbourli Economides
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10794 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johns Hopkins Emergency Medical | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Emergency Care Clinic/Center
- Columbia, MD
- NPI 1922098466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321488000000",
"number": "1023002235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 WYMAN PARK DR",
"address_2": "STE 200",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212112803",
"telephone_number": "410-338-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 EXECUTIVE BLVD",
"address_2": "SUITE 625",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208523803",
"telephone_number": "240-314-7080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECONOMIDES",
"first_name": "AGLAE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-01",
"last_updated": "2011-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TN",
"license": "10794",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3194209",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "376751500",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AGLAE",
"last_name": "ECONOMIDES",
"middle_name": "KOUMBOURLI",
"prefix": "DR.",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.