Letitia Kathlene Thompson Dzirasa, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

22176 Issued in MD

Practice address

1245 Eastern Blvd
Essex, MD 21221-3422

Phone

(410) 558-4700

Fax

(410) 780-0364

NPI assigned

Jun 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Letitia Kathlene Thompson 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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Baltimore Medical System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Baltimore, MD
  • NPI 1164138152
  Medicare reassignment

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1407051709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 SINCLAIR LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212132029",
            "telephone_number": "410-732-8800",
            "fax_number": "410-534-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 EASTERN BLVD",
            "city": "ESSEX",
            "state": "MD",
            "postal_code": "212213422",
            "telephone_number": "410-558-4700",
            "fax_number": "410-780-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON DZIRASA",
        "first_name": "LETITIA",
        "middle_name": "KATHLENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "22176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LETITIA",
            "last_name": "THOMPSON",
            "middle_name": "KATHLENE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy Bliss Tenney, LCPC, LPMT, MT-BC
• Monika Thandalam Somasekar
• The Angel Health Network, LLC
• Carlisa Thomas-Timpson, HS-BCP
• Shanita Thomas
• Bethany Trageser
• Cameran Brythe Trautman, MS, RN, FNP-C
• Trucare
• Tiana Ananda Ushry
• Kimberleigh Vaughan, LCPC

• Pediatrics Physician in Essex, MD
• Providers in Essex, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.