Organization Active NPI

Michael Mardiney, III, M.D. P.a.

Doing business as Mardiney Asthma, Allergy and Immunology Centers

  • Allergy & Immunology Physician
  • Ellicott City, MD
National Provider Identifier
1407239510
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
MICHAEL MARDINEY, III, M.D. P.A.
Doing business as
Mardiney Asthma, Allergy and Immunology Centers
Practice address
3105 N Ridge Rd
Ellicott City, MD 21043-3348
Phone
(410) 461-7660
Fax
(410) 461-2853
NPI assigned
Jul 7, 2015
Last updated
Jul 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Authorized official

Name
Mr. Michael Mardiney III, M.D.NPI 1609827724
Title
President
Phone
(410) 377-6638

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X NU Primary

Addresses

Primary practice location

3105 N Ridge Rd
Ellicott City, MD 21043-3348

Mailing address

PO Box 490
Riderwood, MD 21139-0490
Phone (410) 377-6638

Other names 1

  • Mardiney Asthma, Allergy and Immunology Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150811003887 MD Part B Supplier - Clinic/Group Practice 9032424783 Receives reassigned benefits from 1 practitioner
Practice locations: Ellicott City, MD; Glen Burnie, MD; Lutherville Timonium, MD

National Provider Directory

National Provider Directory

Locations

3105 North Ridge Rd
Ellicott City, MD 21043
Phone (410) 461-7660

22 W Padonia Rd
Ste C144
Lutherville Timonium, MD 21093

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436227200000",
    "number": "1407239510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "RIDERWOOD",
            "state": "MD",
            "postal_code": "211390490",
            "telephone_number": "410-377-6638",
            "fax_number": "410-377-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 N RIDGE RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433348",
            "telephone_number": "410-461-7660",
            "fax_number": "410-461-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL MARDINEY, III, M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A",
        "authorized_official_last_name": "MARDINEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-377-6638",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mardiney Asthma, Allergy and Immunology Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.