Individual provider Active NPI

Mary Clark Magill, NP

  • Family Nurse Practitioner
  • California, MD
National Provider Identifier
1194249177
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R130834 Issued in MD
Practice address
22590 Shady Court
California, MD 20619-5009
Phone
(301) 373-7700
Fax
(301) 373-9197
NPI assigned
Aug 1, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R130834 MD
Family Nurse Practitioner 363LF0000X R130834 MD Primary

Addresses

Primary practice location

22590 Shady Court
California, MD 20619-5009

Mailing address

24035 Three Notch Rd
Hollywood, MD 20636-4871
Phone (301) 373-7900

Other identifiers 1

IdentifierTypeStateIssuer
444072200MedicaidMD

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
I20171109001532 MD Practitioner - Nurse Practitioner 4789940602 Reassigns benefits to 1 organization
I20250714000173 DC Practitioner - Nurse Practitioner 4789940602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group - Southern Maryland LLCGroup PAC ID 1355667056, 241 clinicians

Practice addresses (Care Compare)

22590 Shady CT
California, MD 20619-5009
Phone (301) 373-7900

24035 Three Notch Rd
Hollywood, MD 20636-4871

Hospital & facility affiliations

  • Medstar Saint Mary'S Hospital Hospital, Leonardtown, MD, CCN 210028

Merit-based Incentive Payment System (MIPS)

Final score
81.41 of 100Reported as group
Quality
61.45
Promoting interoperability
96
Improvement activities
40
Cost
79.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R130834MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group - Southern Maryland LLC CurrentSince Sep 11, 2017 Accepting new patients
Medstar Medical Group - Southern Maryland LLC Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Medstar Southern Maryland Physicians, LLC Past Accepting new patients

Locations

22590 Shady Ct
California, MD 20619
Phone (301) 737-0500

950 E Swan Creek Rd
Ft Washington, MD 20744
Phone (301) 292-0236

24035 Three Notch Rd
Hollywood, MD 20636
Phone (301) 373-2588

Interoperability endpoints

  • Direct secure messaging: mary.magillcrnp.p2@direct.msmg.nextgenshare.com

Organizations & group practices 4

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 1

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": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1194249177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24035 THREE NOTCH RD",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206364871",
            "telephone_number": "301-373-7900",
            "fax_number": "301-373-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22590 SHADY COURT",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206195009",
            "telephone_number": "301-373-7700",
            "fax_number": "301-373-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGILL",
        "first_name": "MARY",
        "middle_name": "CLARK",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R130834",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R130834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "444072200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in California, MD

Sources for this page

Verify at the official NPI Registry.