Individual provider Active NPI

Joseph Anthony Maggioncalda II, MD

  • Anesthesiology Physician
  • Myrtle Beach, SC
National Provider Identifier
1134626294
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0101278984 Issued in VA
Practice address
809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone
(843) 692-1595
Fax
(843) 692-1122
NPI assigned
Apr 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101278984 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

809 82ND Pkwy
Myrtle Beach, SC 29572-4607

Mailing address

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230731000572 VA Practitioner - Anesthesiology 5193078962 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Washington Healthcare Specialty Services, LLCGroup PAC ID 5991605826, 136 clinicians

Practice addresses (Care Compare)

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-7614

Hospital & facility affiliations

  • Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022
  • Stafford Hospital, LLC Hospital, Stafford, VA, CCN 490140

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Specialty Services LLC Anesthesiology CurrentSince Jan 1, 2025 Accepting new patients
American Anesthesiology of Virginia, PC Anesthesiology CurrentSince Jun 22, 2023 Accepting new patients
American Anesthesiology of Virginia PC Anesthesiology CurrentSince Jun 22, 2023 Accepting new patients

Locations

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

1201 Sam Perry Blvd
Ste 101
Fredericksburg, VA 22401
Phone (540) 741-4614

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

101 Hospital Center Blvd
Stafford, VA 22554
Phone (540) 741-3340

Interoperability endpoints

  • Direct secure messaging: joseph.maggioncaldaii@hca5.eclinicaldirectplus.com

Organizations & group practices 3

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

Hospital & facility affiliations 4

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": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1134626294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724607",
            "telephone_number": "843-692-1595",
            "fax_number": "843-692-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724607",
            "telephone_number": "843-692-1595",
            "fax_number": "843-692-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGGIONCALDA",
        "first_name": "JOSEPH",
        "middle_name": "ANTHONY",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-06",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101278984",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.