Individual provider Active NPI

Annalisa Debacco Overstreet, M.D.

  • Otolaryngology Physician
  • Annapolis, MD
National Provider Identifier
1184744948
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
D0073946 Issued in MD
Practice address
2002 Medical Pkwy Ste 230
Annapolis, MD 21401-3282
Phone
(410) 266-3900
Fax
(410) 266-9245
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X D0073946 MD Primary

Addresses

Primary practice location

2002 Medical Pkwy Ste 230
Annapolis, MD 21401-3282

Mailing address

2002 Medical Pkwy Ste 230
Annapolis, MD 21401-3282
Phone (410) 266-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20120705000426 MD Practitioner - Otolaryngology 6103081708 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Annapolis ENT Surgical Center LLC CurrentSince Jul 1, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Annapolis ENT Surgical Center, LLC Past Accepting new patients

Locations

2002 Medical Pkwy
Ste 230
Annapolis, MD 21401
Phone (410) 226-3900

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.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1184744948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY STE 230",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013282",
            "telephone_number": "410-266-3900",
            "fax_number": "410-266-9245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY STE 230",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013282",
            "telephone_number": "410-266-3900",
            "fax_number": "410-266-9245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERSTREET",
        "first_name": "ANNALISA",
        "middle_name": "DEBACCO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D0073946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.