Individual provider Active NPI

Anne Marie T Lagoc, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Baltimore, MD
National Provider Identifier
1164405866
Registry record updated Oct 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
D76390 Issued in MD
Practice address
650 W Lombard St
Baltimore, MD 21201-1513
Phone
(410) 328-6335
Fax
(410) 328-6136
NPI assigned
Nov 28, 2005
Last updated
Oct 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 14881 NV
Pediatrics Physician 208000000X 0101235704 VA
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X D76390 MD Primary

Addresses

Primary practice location

650 W Lombard St
Baltimore, MD 21201-1513

Mailing address

PO Box 62063
Baltimore, MD 21264-2063
Phone (410) 706-5181

Other identifiers 1

IdentifierTypeStateIssuer
010116520MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041222000259 DC Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 2961475306 Reassigns benefits to 1 organization
I20050119000209 VA Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 2961475306 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. Pediatrics CurrentSince Jan 1, 2024 Accepting new patients
Commonwealth Emergency Physicians PC CurrentSince Apr 1, 2010 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jan 1, 2024 Accepting new patients
Commonwealth Emergency Physicians PC PastSince Apr 17, 2020 Accepting new patients
Bestpractices, Inc. Past Accepting new patients
Bestpractices, Inc. Past Accepting new patients
University at Buffalo Pediatric Associates Inc Pediatrics PastSince Jan 1, 1998 Accepting new patients

Locations

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

Interoperability endpoints

  • Direct secure messaging: anne.lagoc@pmuc.eclinicaldirectplus.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382313600000",
    "number": "1164405866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62063",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212642063",
            "telephone_number": "410-706-5181",
            "fax_number": "410-706-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 W LOMBARD ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011513",
            "telephone_number": "410-328-6335",
            "fax_number": "410-328-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGOC",
        "first_name": "ANNE MARIE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2013-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "NV",
            "license": "14881",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101235704",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MD",
            "license": "D76390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010116520",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.