Individual provider Active NPI

William E Macdonnell, P.A.

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1225086994
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0002492 Issued in MD
Practice address
1501 W Mount Royal Ave
Baltimore, MD 21217-4289
Phone
(410) 225-4118
Fax
(410) 225-0252
NPI assigned
May 5, 2006
Last updated
Mar 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0002492 MD Primary

Addresses

Primary practice location

1501 W Mount Royal Ave
Baltimore, MD 21217-4289

Mailing address

3500 Boston St Ste J1
Baltimore, MD 21224-5723
Phone (410) 522-0001

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
I20050330000720 MD Practitioner - Physician Assistant 7113973355 Reassigns benefits to 1 organization
I20260223000115 DC Practitioner - Physician Assistant 7113973355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Urgent Care, LLCGroup PAC ID 0749728681, 13 clinicians

Practice addresses (Care Compare)

22750 Newcut Rd
Suite D1B
Clarksburg, MD 20871-5333
Phone (301) 482-1000

9809 Main St
Suite 103
Damascus, MD 20872-2090
Phone (301) 482-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0002492MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Urgent Care, LLC CurrentSince Nov 15, 2025 Accepting new patients
Atlantic Physician Services of Maryland, PC Physician Assistant CurrentSince Dec 1, 2001 Accepting new patients
Maryland Institute College of Art CurrentSince Aug 28, 2022 Accepting new patients
Atlantic Physician Services of Maryland, P.C. Physician Assistant CurrentSince Dec 1, 2001 Accepting new patients
Dresnick Sterling Emergency Physicians of Maryland PA Past Accepting new patients
Clarksburg Urgent Care LLC PastSince Feb 14, 2021 Accepting new patients
Charles Emergency Physicians PA Past Accepting new patients

Locations

1501 W Mount Royal Ave
Baltimore, MD 21217
Phone (410) 225-4118

1501 W Mount Royal Ave
Ste 2
Baltimore, MD 21217
Phone (410) 225-4118

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

22750 Newcut Rd
Ste D1B
Clarksburg, MD 20871
Phone (301) 302-8513

9809 Main St
Ste 103
Damascus, MD 20872
Phone (301) 482-1000

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, 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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1225086994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 BOSTON ST STE J1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245723",
            "telephone_number": "410-522-0001",
            "fax_number": "410-522-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W MOUNT ROYAL AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212174289",
            "telephone_number": "410-225-4118",
            "fax_number": "410-225-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONNELL",
        "first_name": "WILLIAM",
        "middle_name": "E",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.