Individual provider Active NPI

Debra M. Piccirillo

  • Speech-Language Pathologist
  • Millersville, MD
National Provider Identifier
1376817908
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
06835 Issued in MD
Practice address
8638 Veterans Hwy
1St Floor
Millersville, MD 21108-1422
Phone
(410) 729-4508
Fax
(410) 729-4526
NPI assigned
Feb 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 06835 MD Primary
Speech-Language Pathologist 235Z00000X 2202003503 VA

Addresses

Primary practice location

8638 Veterans Hwy
1St Floor
Millersville, MD 21108-1422

Mailing address

PO Box 15945
Belfast, ME 04915-4054
Phone (410) 729-4508

Other identifiers 1

IdentifierTypeStateIssuer
500208700MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161004002327 MD Practitioner - Qualified Speech Language Pathologist 7618265877 Reassigns benefits to 1 organization
I20161005000594 DC Practitioner - Qualified Speech Language Pathologist 7618265877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
LHMG Physical Therapy, LLCGroup PAC ID 3870893738, 101 clinicians

Practice addresses (Care Compare)

28438 Marlboro Ave
Easton, MD 21601-2732
Phone (443) 481-1140

4175 N Hanson Court
Suite 301
Bowie, MD 20716-3179
Phone (301) 805-7004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06835MDMDSpeech-Language Pathologist
2202003503VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
LHMG Physical Therapy, LLC CurrentSince Oct 1, 2016 Accepting new patients
LHMG Physical Therapy, LLC CurrentSince Oct 1, 2016 Accepting new patients
LHMG Physical Therapy, LLC CurrentSince Oct 1, 2016 Accepting new patients

Locations

161 Jennifer Rd
Ste A
Annapolis, MD 21401

1332 Cape St Claire Rd
Annapolis, MD 21409
Phone (443) 481-5618

6836 Race Track Rd
Bowie, MD 20715
Phone (301) 805-7004

4175 N Hanson Ct
Ste 304
Bowie, MD 20716
Phone (301) 352-4007

15500 Annapolis Rd
Ste 102
Bowie, MD 20715
Phone (301) 805-0190

4175 N Hanson Ct
Ste 301
Bowie, MD 20716
Phone (301) 805-0190

1630 Main St
Chester, MD 21619
Phone (410) 604-2555

1630 Main St
Ste 109
Chester, MD 21619
Phone (410) 604-2424

28438 Marlboro Ave
Easton, MD 21601
Phone (410) 820-7270

70 Central Ave W
Edgewater, MD 21037
Phone (410) 481-1140

1153 State Route 3 N
Ste 35
Gambrills, MD 21054
Phone (410) 216-2200

8638 Veterans Hwy
Fl 1
Millersville, MD 21108
Phone (410) 729-4508

1106 Annapolis Rd
Ste 120
Odenton, MD 21113
Phone (410) 674-1650

8109 Ritchie Hwy
Ste 600
Pasadena, MD 21122
Phone (410) 553-3515

820 Ritchie Hwy
Ste 100
Severna Park, MD 21146
Phone (410) 544-6813

5801 Allentown Rd
Ste 200
Suitland, MD 20746
Phone (240) 842-1435

7611 Crain Hwy
Ste C170
Upper Marlboro, MD 20772

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": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1376817908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15945",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154054",
            "telephone_number": "410-729-4508",
            "fax_number": "410-729-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8638 VETERANS HWY",
            "address_2": "1ST FLOOR",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081422",
            "telephone_number": "410-729-4508",
            "fax_number": "410-729-4526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICCIRILLO",
        "first_name": "DEBRA",
        "middle_name": "M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "06835",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202003503",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500208700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millersville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.