Individual provider Active NPI

Andrea Ceccarelli Cuniff, M.D.

  • Family Medicine Physician
  • Pasadena, MD
National Provider Identifier
1467634196
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0068440 Issued in MD
Practice address
24 Magothy Beach Rd Ste a
Pasadena, MD 21122-4414
Phone
(410) 255-2700
Fax
(410) 437-1962
NPI assigned
Dec 5, 2007
Last updated
Jan 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X P20837 MD
Family Medicine Physician 207Q00000X D0068440 MD Primary

Addresses

Primary practice location

24 Magothy Beach Rd Ste a
Pasadena, MD 21122-4414

Mailing address

1111 Benfield Blvd
Suite 200
Millersville, MD 21108-3002
Phone (410) 729-5100

Other identifiers 10

IdentifierTypeStateIssuer
12753739OtherMDMULTIPLAN/PHCS PROVIDER NUMBER
418708300MedicaidMD
6954391OtherMDAETNA PPO
7605-0106OtherMDCAREFIRST BLUE CHOICE
957078-04OtherMDCAREFIRST- MD RENDERING
P18916OtherMDCAREFIRST MPOS
9385370OtherMDAETNA HMO
P00794930OtherMDRAILROAD MEDICARE
226988OtherMDJHHC PROVIDER NUMBER
8246382OtherMDMAMSI

Other names 1

  • Dr. Andrea Stephanie Ceccarelli Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091201000595 MD Practitioner - Family Practice 5294874400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Maryland School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maryland Primary Care Physicians, LLCGroup PAC ID 8729981832, 101 clinicians

Practice addresses (Care Compare)

129 Lubrano Dr
Suite 100
Annapolis, MD 21401-7566
Phone (410) 266-5852

1509 Ritchie Hwy
Arnold, MD 21012-2742
Phone (410) 757-7600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P20837MDMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Primary Care Physicians, LLC CurrentSince Jun 2, 2010 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

129 Lubrano Dr
Ste 100
Annapolis, MD 21401
Phone (410) 266-5852

1509 Ritchie Hwy
Arnold, MD 21012
Phone (410) 757-1600

24 Magothy Beach Rd
Ste A
Pasadena, MD 21122
Phone (410) 255-2700

125 Shoreway Dr
Ste 120
Queenstown, MD 21658
Phone (410) 643-7800

Organizations & group practices 2

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 5

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": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1467634196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BENFIELD BLVD",
            "address_2": "SUITE 200",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211083002",
            "telephone_number": "410-729-5100",
            "fax_number": "410-729-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MAGOTHY BEACH RD STE A",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211224414",
            "telephone_number": "410-255-2700",
            "fax_number": "410-437-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNIFF",
        "first_name": "ANDREA",
        "middle_name": "CECCARELLI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": "P20837",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0068440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN/PHCS PROVIDER NUMBER",
            "identifier": "12753739",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "418708300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "6954391",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CHOICE",
            "identifier": "7605-0106",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST- MD RENDERING",
            "identifier": "957078-04",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MPOS",
            "identifier": "P18916",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "9385370",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00794930",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JHHC PROVIDER NUMBER",
            "identifier": "226988",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "8246382",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "CECCARELLI",
            "middle_name": "STEPHANIE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pasadena, MD

Sources for this page

Verify at the official NPI Registry.