Individual provider Active NPI

Avena Flaharty, PA-C

  • Medical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1447492897
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0003196 Issued in MD
Practice address
827 Linden Ave
Baltimore, MD 21201-4606
Phone
(410) 225-8000
NPI assigned
Apr 1, 2009
Last updated
Apr 1, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0003196 MD Primary

Addresses

Primary practice location

827 Linden Ave
Baltimore, MD 21201-4606

Mailing address

PO Box 1574
Loma Linda, CA 92354-1574
Phone (213) 248-8686

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160111002700 MD Practitioner - Physician Assistant 3476580002 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Agnes Healthcare IncGroup PAC ID 9830092733, 265 clinicians

Practice addresses (Care Compare)

900 Caton Ave
Baltimore, MD 21229-5201
Phone (667) 234-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0003196MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Agnes Healthcare Inc CurrentSince Oct 1, 2024 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Maryland General Clinical Practice Group, Inc. CurrentSince Aug 17, 2021 Accepting new patients
St Agnes Healthcare Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238544000000",
    "number": "1447492897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1574",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923541574",
            "telephone_number": "213-248-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 LINDEN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014606",
            "telephone_number": "410-225-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAHARTY",
        "first_name": "AVENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-01",
        "last_updated": "2009-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0003196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.