Elba M. Pacheco, M.D., LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

D38556 Issued in MD

Legal business name

ELBA M. PACHECO, M.D., LLC

Practice address

692A Ritchie Hwy
Suite 2B
Severna Park, MD 21146-3971

Phone

(410) 647-0123

Fax

(410) 647-0126

NPI assigned

May 5, 2009

Organization subpart

No

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

Authorized official

Name

Elba M. Pacheco, MDNPI 1972565406

Title

President

Phone

(410) 647-0123

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elba M Pacheco, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Severna Park, MD
  • NPI 1972565406

  Ophthalmology

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241481600000",
    "number": "1447484597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "692A RITCHIE HWY",
            "address_2": "SUITE 2B",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463971",
            "telephone_number": "410-647-0123",
            "fax_number": "410-647-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "692A RITCHIE HWY",
            "address_2": "SUITE 2B",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463971",
            "telephone_number": "410-647-0123",
            "fax_number": "410-647-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELBA M. PACHECO, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2009-05-05",
        "status": "A",
        "authorized_official_last_name": "PACHECO",
        "authorized_official_first_name": "ELBA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-647-0123",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D38556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eddie Lomash LLC
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• Nicole Ehrlich
• Elaine Crain LLC
• Elaine M Arata, M.D.
• Storm Emerson, LCPC
• Empowerment Solutions, Inc.
• Karen Ann Engel-Thompson III, APRN, BC, PHM
• Breon B Engram
• Lisa M Ensley, BEHAVIOR TECHNICIAN

• Ophthalmology Physician in Severna Park, MD
• Providers in Severna Park, MD by specialty
• Ophthalmology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2009; 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.