NPIMap

Organization Active NPI

Mace Medical LLC

  • Internal Medicine Physician
  • Essex, MD
National Provider Identifier
1114374360
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MACE MEDICAL LLC
Practice address
1124 Mace Ave
Essex, MD 21221-3315
Phone
(410) 391-6996
Fax
(410) 687-6877
NPI assigned
May 18, 2016
Last updated
May 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Authorized official

Name
Dr. John M Lee, M.D.NPI 1275849051
Title
Physician
Phone
(410) 391-6996

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1124 Mace Ave
Essex, MD 21221-3315

Mailing address

1124 Mace Ave
Essex, MD 21221-3315
Phone (410) 391-6996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161212001544 MD Part B Supplier - Clinic/Group Practice 8123308020 Receives reassigned benefits from 19 practitioners
Practice locations: Baltimore, MD; Dundalk, MD

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JHCFBA

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1114374360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 MACE AVE",
            "city": "ESSEX",
            "state": "MD",
            "postal_code": "212213315",
            "telephone_number": "410-391-6996",
            "fax_number": "410-687-6877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 MACE AVE",
            "city": "ESSEX",
            "state": "MD",
            "postal_code": "212213315",
            "telephone_number": "410-391-6996",
            "fax_number": "410-687-6877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "410-391-6996",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.