NPIMap

Individual provider Active NPI

Marielie Heidi Agesilas, M.D.

  • Family Medicine Physician
  • Springdale, AR
National Provider Identifier
1073809158
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-8365 Issued in AR
Practice address
2422 N Thompson St
Springdale, AR 72764-1757
Phone
(479) 750-6585
Fax
(479) 750-6594
NPI assigned
Jun 27, 2011
Last updated
Jun 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-8365 AR Primary

Addresses

Primary practice location

2422 N Thompson St
Springdale, AR 72764-1757

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other practice location 1

1125 N College Ave
Fayetteville, AR 72703-1908
Phone (479) 521-8260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140514000476 AR Practitioner - Family Practice 9739302068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Arkansas for Medical SciencesGroup PAC ID 4082528955, shared by 29 NPIs, 1,159 clinicians

Practice addresses (Care Compare)

1125 N College Ave
Uams Family Medical Center
Fayetteville, AR 72703-1908
Phone (479) 521-8260

601 W Maple Ave
102 Northwest Family Med CT
Springdale, AR 72764-5370
Phone (479) 750-6585

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-8365ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Family Medicine CurrentSince Jul 1, 2014 Accepting new patients
University of Arkansas for Medical Sciences Family Medicine CurrentSince Jul 1, 2014 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
University of Arkansas for Medical Sciences Family Medicine CurrentSince Jul 1, 2014 Accepting new patients
University of Arkansas for Medical Sciences Family Medicine Past Accepting new patients

Locations

1125 N College Ave
Fayetteville, AR 72703
Phone (479) 521-8260

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

601 W Maple Ave
Ste 102
Springdale, AR 72764
Phone (479) 750-6585

Organizations & group practices 5

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

Hospital & facility affiliations 3

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": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1073809158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 N THOMPSON ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727641757",
            "telephone_number": "479-750-6585",
            "fax_number": "479-750-6594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 N College Ave",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727031908",
            "country_code": "US",
            "telephone_number": "479-521-8260",
            "fax_number": "479-443-3903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGESILAS",
        "first_name": "MARIELIE",
        "middle_name": "HEIDI",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-8365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.