Karl Peter Malicdem, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

DA2123 Issued in MD

Practice address

1209 York Rd
Suite 200
Lutherville, MD 21093-6207

Phone

(410) 821-9490

Fax

(410) 821-9495

NPI assigned

Oct 28, 2008

Last updated

Oct 28, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

New England College of Optometry, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Care Associates of Maryland LLCGroup PAC ID 1850491994, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: karl.malicdem.p1@direct.levineyecare.nextgenshare.com

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.

• Eye Care Associates of MD, LLC

  • Ophthalmology Physician
  • Nottingham, MD
  • NPI 1588784235

  Optometrist

  Medicare reassignment Care Compare group NPD
• Katzen Medical Associates, PC

  dba National Retina Institute

  • Ophthalmology Physician
  • Lutherville, MD
  • NPI 1326052614

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1255584793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 YORK RD",
            "address_2": "SUITE 200",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936207",
            "telephone_number": "410-821-9490",
            "fax_number": "410-821-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 YORK RD",
            "address_2": "SUITE 200",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936207",
            "telephone_number": "410-821-9490",
            "fax_number": "410-821-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALICDEM",
        "first_name": "KARL",
        "middle_name": "PETER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "DA2123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Mackenzie
• Mady and Mules, PA
• Beth M Magaziner, LCSW-C
• Jeffrey L Magaziner, M.D.
• Eric Mahabir, PT, DPT
• Saroja Mallik, MD
• Jasmine Niquelle Manley, MD
• Charles Mann, D.M.D
• Annette Rossi Mannion, CPNP
• Paul Manson, M.D.

• Optometrist in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.