Marielie Heidi Agesilas, M.D.
Individual provider Active NPI Family Medicine Physician · Springdale, AR
NPI 1073809158 · NPPES record last updated Jun 16, 2026
Key facts
- NPI
- 1073809158
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- E-8365 (AR)
- Practice address
- 2422 N Thompson St
Springdale, AR 72764-1757 - Phone
- (479) 750-6585
- Fax
- (479) 750-6594
- NPI assigned
- Jun 27, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Arkansas for Medical Sciences
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
- University of Arkansas Medical Sciences
- Washington Regional Medical Center
- Northwest Medical Center-Springdale
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140514000476 | AR | Practitioner - Family Practice | 9739302068 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-8365 | AR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Arkansas for Medical Sciences | Family Medicine | Current |
Accepting new patients |
| University of Arkansas for Medical Sciences | Family Medicine | Current |
Accepting new patients |
| University of Arkansas for Medical Sciences | Current | Accepting new patients | |
| University of Arkansas for Medical Sciences | Family Medicine | Current |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | E-8365 | AR | Yes |
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
NPI Registry JSON
{
"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
- Serrhel G Adams Jr.
- Adapthealth - Missouri LLC
- Advanced Monitoring Services LLC
- Carol Ed Agana
- Ami Agbabli
- Ahm Action Home Health, LP
- Ahm Action Home Health, LP
- Ahr Springdale TRS Sub, LLC
- Christina Lynne Ahrens
- Michelle Lee Aiken
All providers in Springdale, AR · Family Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.