Individual provider Active NPI

Eric Charles Marcalus, MD

  • Internal Medicine Physician
  • Edgewater, MD
National Provider Identifier
1336190248
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D58166 Issued in MD
Practice address
3168 Braverton St Ste 250
Edgewater, MD 21037-2682
Phone
(410) 956-1600
Fax
(410) 956-7900
NPI assigned
May 15, 2006
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D58166 MD Primary

Addresses

Primary practice location

3168 Braverton St Ste 250
Edgewater, MD 21037-2682

Mailing address

3168 Braverton St
Suite 250
Edgewater, MD 21037-2674
Phone (410) 956-1600

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090610000065 MD Practitioner - Internal MedicinePractitioner - Family Practice 5193875391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3168 Braverton St
Suite 250
Edgewater, MD 21037-2682
Phone (410) 956-1600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D58166MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South River Internal Medicine, PA Internal Medicine CurrentSince Jan 1, 2009 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3168 Braverton St
Ste 250
Edgewater, MD 21037
Phone (410) 956-1600

3169 Braverton St
Ste 101
Edgewater, MD 21037
Phone (410) 956-5076

Interoperability endpoints

  • Direct secure messaging: eric.marcalus.1@11137.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1336190248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3168 BRAVERTON ST",
            "address_2": "SUITE 250",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210372674",
            "telephone_number": "410-956-1600",
            "fax_number": "410-956-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3168 BRAVERTON ST STE 250",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210372682",
            "telephone_number": "410-956-1600",
            "fax_number": "410-956-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCALUS",
        "first_name": "ERIC",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D58166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, MD

Sources for this page

Verify at the official NPI Registry.