Individual provider Active NPI

Laurie B Gezelle, PA

  • Physician Assistant
  • Annapolis, MD
National Provider Identifier
1245429000
Registry record updated Nov 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0003630 Issued in MD
Practice address
2001 Medical Pkwy
Annapolis, MD 21401-3280
Phone
(443) 481-3751
NPI assigned
Oct 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2007

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 C0003630 MD Primary

Addresses

Primary practice location

2001 Medical Pkwy
Annapolis, MD 21401-3280

Mailing address

2001 Medical Pkwy
Annapolis, MD 21401-3280

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
I20080125000559 MD Practitioner - Physician Assistant 2264514512 Reassigns benefits to 7 organizations
I20140509001004 DC Practitioner - Physician Assistant 2264514512 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adfinitas Health at Encompass Rehab LLCGroup PAC ID 6103283379, 8 clinicians

Practice addresses (Care Compare)

17351 Melford Blvd
Bowie, MD 20715-4457
Phone (240) 548-1300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mdics Rehabilitative Services - Ltcaco LLC CurrentSince Nov 1, 2025 Accepting new patients
Genesis Eldercare Physician Services LLC CurrentSince Dec 27, 2014 Accepting new patients
Genesis Eldercare Physician Services LLC CurrentSince Dec 27, 2014 Accepting new patients
Genesis Eldercare Physician Services LLC CurrentSince Dec 27, 2014 Accepting new patients
Maryland Inpatient Care Specialists LLC Past Accepting new patients

Locations

3939 Penhurst Ave
Baltimore, MD 21215
Phone (410) 664-9535

3330 Wilkens Ave
Baltimore, MD 21229
Phone (410) 525-1544

7520 Surratts Rd
Clinton, MD 20735
Phone (301) 856-1600

347 Ballenger Center Dr
Frederick, MD 21703
Phone (301) 633-5181

121 Morris Dr
La Plata, MD 20646
Phone (410) 999-1133

1801 Wentworth Rd
Parkville, MD 21234
Phone (410) 661-5717

9200 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 390-2600

310 Genesis Way
Ste 600
Severna Park, MD 21146
Phone (410) 544-4220

2101 Fairland Rd
Silver Spring, MD 20904
Phone (301) 384-6161

3227 Bel Pre Rd
Silver Spring, MD 20906
Phone (301) 871-2000

2700 Barker St
Silver Spring, MD 20910
Phone (301) 565-0300

Organizations & group practices 11

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 2

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": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195776000000",
    "number": "1245429000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MEDICAL PKWY",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MEDICAL PKWY",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013280",
            "telephone_number": "443-481-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEZELLE",
        "first_name": "LAURIE",
        "middle_name": "B",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0003630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.