Mafot & Associates Medical Services LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

D0073466 Issued in MD

Legal business name

MAFOT & ASSOCIATES MEDICAL SERVICES LLC

Practice address

1403 Madison Park Dr Ste 200
Glen Burnie, MD 21061-6427

Phone

(410) 487-6902

Fax

(410) 487-6982

NPI assigned

Jan 18, 2014

Organization subpart

No

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

Authorized official

Name

Dagobert Simo, MDNPI 1144458217

Title

Director

Phone

(240) 432-1924

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dagobert Simo, MD

  • Internal Medicine Physician
  • Glen Burnie, MD
  • NPI 1144458217
  Medicare reassignment NPD Authorized official
• Armel Simo, M.D.

  • Family Medicine Physician
  • Catonsville, MD
  • NPI 1376708321
  Medicare reassignment NPD
• Kenneth Geh, MD

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1396718755
  NPD (past)

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

{
    "created_epoch": "1390003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661904000000",
    "number": "1104248541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11183 COLUMBIA PIKE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209014507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 MADISON PARK DR STE 200",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210616427",
            "telephone_number": "410-487-6902",
            "fax_number": "410-487-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAFOT & ASSOCIATES MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-18",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A",
        "authorized_official_last_name": "SIMO",
        "authorized_official_first_name": "DAGOBERT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "240-432-1924",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "MD",
            "license": "D0073466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracey Mack
• Raylin Tanae Mackall
• Alvin Serrano Madarang, M.D.
• Madden Anesthesia LLC
• Malia Maddox
• Marissa Mallari Magtanong, NP
• Mary Lou Maguire
• Krista Marie Mahaney, PT
• Cara Mahoney, AU.D.
• Susan L Maier, MD

• General Practice Physician in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• General Practice Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.