Individual provider Active NPI

Massimo S. Fiandaca, M.D.

  • Specialist
  • Columbia, MD
National Provider Identifier
1326063264
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D41956 Issued in MD
Practice address
11055 Little Patuxent Pkwy
Suite 209
Columbia, MD 21044-2896
Phone
(410) 772-3685
Fax
(410) 772-3686
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D41956 MD Primary

Addresses

Primary practice location

11055 Little Patuxent Pkwy
Suite 209
Columbia, MD 21044-2896

Mailing address

402 Wildberry CT
Millersville, MD 21108-1888
Phone (410) 772-3685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Massimo S Fiandaca MD PA PastSince Apr 29, 2001 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Charles J. Lancelotta Jr., M.D., P.a. Specialist PastSince Aug 1, 2004 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1326063264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 WILDBERRY CT",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081888",
            "telephone_number": "410-772-3685",
            "fax_number": "410-772-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11055 LITTLE PATUXENT PKWY",
            "address_2": "SUITE 209",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442896",
            "telephone_number": "410-772-3685",
            "fax_number": "410-772-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIANDACA",
        "first_name": "MASSIMO",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D41956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.