NPIMap

Individual provider Active NPI

Nnaemeka Agajelu, M.D

  • Internal Medicine Physician
  • Glen Burnie, MD
National Provider Identifier
1104891886
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0056950 Issued in MD
Practice address
85 Kindred Way
Suite 101
Glen Burnie, MD 21061
Phone
(410) 553-6360
Fax
(410) 553-6661
NPI assigned
Feb 17, 2006
Last updated
Mar 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0056950 MD Primary

Addresses

Primary practice location

85 Kindred Way
Suite 101
Glen Burnie, MD 21061

Mailing address

85 Kindred Way
Suite 101
Glen Burnie, MD 21061
Phone (410) 553-6360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20040414001595 MD Practitioner - Internal Medicine 5193719789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nnaemeka Agajelu MD LLCGroup PAC ID 8426008137, 2 clinicians

Practice addresses (Care Compare)

85 Kindred Way
Apt 101
Glen Burnie, MD 21061-5246
Phone (410) 553-6360

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0056950MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Horizon Healthcare LLC Internal Medicine Current Accepting new patients
Nnaemeka Agajelu MD LLC Internal Medicine CurrentSince Sep 1, 2004 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Chesapeake Primary Care Group PA Internal Medicine PastSince Sep 1, 1996 Accepting new patients
Ruben Reider MD PA Internal Medicine Past Accepting new patients

Locations

85 Kindred Way
Apt 101
Glen Burnie, MD 21061
Phone (410) 553-6360

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/28227/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nagajelu20001@direct.umm.edu

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 7

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1104891886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 KINDRED WAY",
            "address_2": "SUITE 101",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-553-6360",
            "fax_number": "410-553-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 KINDRED WAY",
            "address_2": "SUITE 101",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-553-6360",
            "fax_number": "410-553-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGAJELU",
        "first_name": "NNAEMEKA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0056950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.