Active NPI
Mary Elizabeth Aichelmann-Reidy, DDS
- Periodontics
- Baltimore, MD
National Provider Identifier
1073653002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 34
- Practice address
- 650 West Baltimore Street,
Room, 4209, Department of Periodontics
Baltimore, MD 21201-1510 - Phone
- (410) 706-7153
- NPI assigned
- Feb 7, 2007
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 34 | MD | Primary |
Addresses
Primary practice location
650 West Baltimore Street,
Room, 4209, Department of Periodontics
Baltimore, MD 21201-1510
Mailing address
650 W. Baltimore Street,
Room, 4209, Department of Periodontics
Baltimore, MD 21201-1510
Phone (410) 706-7153
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151221000065 | MD | Order and Referring Only - Dentist | 2466753298 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34 | MD | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073653002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 W. BALTIMORE STREET,",
"address_2": "ROOM, 4209, DEPARTMENT OF PERIODONTICS",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011510",
"telephone_number": "410-706-7153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 WEST BALTIMORE STREET,",
"address_2": "ROOM, 4209, DEPARTMENT OF PERIODONTICS",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011510",
"telephone_number": "410-706-7153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AICHELMANN-REIDY",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MD",
"license": "34",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.