Individual provider Active NPI

Agisilaos Makrodimitris, PA

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1144326703
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C02281 Issued in MD
Practice address
210 E University Pkwy
Baltimore, MD 21218-2828
Phone
(202) 877-9696
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C02281 MD Primary

Addresses

Primary practice location

210 E University Pkwy
Baltimore, MD 21218-2828

Mailing address

1000 River Rd
Ste 100
Conshohocken, PA 19428-2439
Phone (800) 355-3818

Other identifiers 1

IdentifierTypeStateIssuer
970016787OtherMDRAILROAD MED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100603000491 MD Practitioner - Physician Assistant 1951430784 Reassigns benefits to 3 organizations
I20250505001030 DC Practitioner - Physician Assistant 1951430784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as group
Quality
80.29
Promoting interoperability
100
Improvement activities
40
Cost
75.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C02281MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Urgent Care LLC CurrentSince Feb 26, 2020 Accepting new patients
WHC Emerg Phys CurrentSince Mar 1, 2020 Accepting new patients
Medstar Urgent Care, LLC CurrentSince Feb 26, 2020 Accepting new patients
WHC Physician Group LLC CurrentSince Mar 1, 2020 Accepting new patients
Medstar Medical Group II LLC CurrentSince Feb 26, 2020 Accepting new patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
Medlantic Healthcare Group Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

3001 S Hanover St
Brooklyn Park, MD 21225
Phone (410) 350-3200

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11355 Pembrooke Sq
Ste 108
Waldorf, MD 20603
Phone (202) 877-6733

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1144326703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 RIVER RD",
            "address_2": "STE 100",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282439",
            "telephone_number": "800-355-3818",
            "fax_number": "610-834-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E UNIVERSITY PKWY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182828",
            "telephone_number": "202-877-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKRODIMITRIS",
        "first_name": "AGISILAOS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C02281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MED",
            "identifier": "970016787",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.