Jeannine Mogavero Theoret, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D0062774 Issued in MD

Practice address

116 Defense Hwy Ste 403
Annapolis, MD 21401-7020

Phone

(410) 844-8998

NPI assigned

Jun 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jeannine Mogavero Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: jeannine.mogavero.theoret.1@19111.direct.athenahealth.com

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1437190154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 SEVERNSIDE DR",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462200",
            "telephone_number": "617-901-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 DEFENSE HWY STE 403",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017020",
            "telephone_number": "410-844-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGAVERO THEORET",
        "first_name": "JEANNINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MD",
            "license": "D0062774",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0062774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNINE",
            "last_name": "MOGAVERO",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Modern Dermatology of Maryland, LLC
• Jitendrakumar Rajnikant Modi, M.D.
• Kim Modica
• Lyle Terrence Modlin, D.P.M.
• Milan Pankaj Mody, P.A.
• Cyndra Renee Mogayzel, M.D.
• John C Moghtader, M.D.
• Zayed Mohiyuddin, M.B.,B.S.
• Madelaina Elise Molik
• S. Sharon Moline, PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; 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.