Individual provider Active NPI

Alexa Maria Dipeso, CRNP

  • Primary Care Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1053169599
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R235308 Issued in MD
Practice address
7106 Ridge Rd Ste B
Baltimore, MD 21237-3883
Phone
(410) 687-2300
NPI assigned
May 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R235308 MD
Primary Care Nurse Practitioner 363LP2300X R235308 MD Primary

Addresses

Primary practice location

7106 Ridge Rd Ste B
Baltimore, MD 21237-3883

Mailing address

7106 Ridge Rd Ste B
Rosedale, MD 21237-3883
Phone (410) 687-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20240731003818 MD Practitioner - Nurse Practitioner 2860939469 Reassigns benefits to 2 organizations
I20260421003904 DC Practitioner - Nurse Practitioner 2860939469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 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

7801 York Rd
Suite 102
Towson, MD 21204-7447
Phone (410) 769-4920

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R235308MDMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jun 19, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jun 19, 2024 Accepting new patients

Locations

3007 Tilden St NW
Ste 5N
Washington, DC 20008

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

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

7106 Ridge Rd
Ste B
Rosedale, MD 21237
Phone (410) 687-2300

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1715212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1053169599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7106 RIDGE RD STE B",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212373883",
            "telephone_number": "410-687-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7106 RIDGE RD STE B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373883",
            "telephone_number": "410-687-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPESO",
        "first_name": "ALEXA",
        "middle_name": "MARIA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R235308",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R235308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.