Individual provider Active NPI

Pio L. Poblete, M.D.

  • Internal Medicine Physician
  • Columbia, MD
National Provider Identifier
1215929112
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0050338 Issued in MD
Practice address
5900 Waterloo Rd Ste 200
Columbia, MD 21045-2641
Phone
(410) 740-2900
Fax
(410) 992-0732
NPI assigned
Aug 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0050338 MD Primary

Addresses

Primary practice location

5900 Waterloo Rd Ste 200
Columbia, MD 21045-2641

Mailing address

7580 Buckingham Blvd Ste 220
Hanover, MD 21076-3210
Phone (410) 729-5100

Other identifiers 11

IdentifierTypeStateIssuer
110161664OtherMDRR MEDICARE
543574-02OtherMDCAREFIRST MD RENDERING
029921OtherMDJHHC PROVIDER NUMBER
0568716OtherMDAETNA CAPITATED
443211800MedicaidMD
P12724OtherMDCAREFIRST MPOS
5918117OtherMDAETNA FEE FOR SERVICE
860239OtherMDMAMSI PRIMARY CARE
3509-0009OtherMDCAREFIRST BLUECHOICE
260239OtherMDMAMSI SPECIALIST
3117511OtherMDCIGNA PIN

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
I20100708000570 MD Practitioner - Internal Medicine 2466583422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Virginia School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maryland Primary Care Physicians, LLCGroup PAC ID 8729981832, 101 clinicians

Practice addresses (Care Compare)

11055 Little Patuxent Pkwy
Suite 103
Columbia, MD 21044-2908
Phone (410) 740-0770

Hospital & facility affiliations

  • Bayada Home Health Care, Inc. Home health agency, Towson, MD, CCN 217101
  • Amedisys Home Health Home health agency, Westminster, MD, CCN 217048

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0050338MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Primary Care Physicians, LLC CurrentSince Feb 1, 1997 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1509 Ritchie Hwy
Arnold, MD 21012
Phone (410) 757-1600

5900 Waterloo Rd
Ste 200
Columbia, MD 21045
Phone (410) 321-8452

11055 Little Patuxent Pkwy
Ste 103
Columbia, MD 21044
Phone (410) 740-0770

7580 Buckingham Blvd
Ste 220
Hanover, MD 21076
Phone (410) 729-5100

1111 Benfield Blvd
Ste 200
Millersville, MD 21108
Phone (410) 729-5100

Organizations & group practices 2

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 6

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1215929112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 BUCKINGHAM BLVD STE 220",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210763210",
            "telephone_number": "410-729-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 WATERLOO RD STE 200",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452641",
            "telephone_number": "410-740-2900",
            "fax_number": "410-992-0732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POBLETE",
        "first_name": "PIO",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0050338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110161664",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD RENDERING",
            "identifier": "543574-02",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JHHC PROVIDER NUMBER",
            "identifier": "029921",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CAPITATED",
            "identifier": "0568716",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "443211800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MPOS",
            "identifier": "P12724",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA FEE FOR SERVICE",
            "identifier": "5918117",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI PRIMARY CARE",
            "identifier": "860239",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECHOICE",
            "identifier": "3509-0009",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI SPECIALIST",
            "identifier": "260239",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "3117511",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.