Active NPI
Agisilaos Makrodimitris, PA
- Physician Assistant
- Baltimore, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C02281
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 970016787 | Other | MD | RAILROAD MED |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 94.27 of 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| C02281 | MD | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Urgent Care LLC | Current | Accepting new patients | |
| WHC Emerg Phys | Current | Accepting new patients | |
| Medstar Urgent Care, LLC | Current | Accepting new patients | |
| WHC Physician Group LLC | Current | Accepting new patients | |
| Medstar Medical Group II LLC | Current | Accepting new patients | |
| Medstar Medical Group II LLC | Current | 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.
-
- Urgent Care Clinic/Center
- Baltimore, MD
- NPI 1902175870
-
- General Practice Physician
- Lexington Park, MD
- NPI 1275410474
-
- Urgent Care Clinic/Center
- Wheaton, MD
- NPI 1871843409
-
- Internal Medicine Physician
- Washington, DC
- NPI 1376887844
-
- Hospitalist Physician
- Washington, DC
- NPI 1770198301
-
- Emergency Medical Services (Emergency Medicine) Physician
- Washington, DC
- NPI 1306260625
-
- Emergency Medicine Physician
- Baltimore, MD
- NPI 1467408450
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.