Michelle Arlene Demattia, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C05800 Issued in MD

Practice address

71 Old Mill Bottom Rd N
Suite 300
Annapolis, MD 21409-5410

Phone

(410) 268-3887

Fax

(410) 268-8171

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Michelle Arlene Campbell Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Derm Associates LLCGroup PAC ID 4688653306, 44 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mdemattia@usdp7.emadirect.md

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.

• Derm Associates LLC

  • Dermatology Physician
  • Silver Spring, MD
  • NPI 1649271354
  Medicare reassignment Care Compare group
• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984

  Physician Assistant

  NPD (past)
• Virginia Dermatology and Skin Surgery Center

  • MOHS-Micrographic Surgery Physician
  • Fredericksburg, VA
  • NPI 1598056582
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1316056575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 OLD MILL BOTTOM RD N",
            "address_2": "SUITE 300",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214095410",
            "telephone_number": "410-268-3887",
            "fax_number": "410-268-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 OLD MILL BOTTOM RD N",
            "address_2": "SUITE 300",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214095410",
            "telephone_number": "410-268-3887",
            "fax_number": "410-268-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMATTIA",
        "first_name": "MICHELLE",
        "middle_name": "ARLENE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004351",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C05800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "CAMPBELL",
            "middle_name": "ARLENE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kennedy Dele, D.M.D
• John G. Deleonibus, D.P.M.
• Karen Dell, COTA
• Gary J Della'Zanna, DO
• Ruben Delpilar, M.D.
• Patrick Demichele
• Vladimir Demidov, MD
• Brendan Dempsey, MD
• Meghan Dempsey, MS, LCAT, BC-DMT, NC
• Cecelia Denne, MGC

• Medical Physician Assistant in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; 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.