Zelbesa Vailiida Dakue Mack, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R137492 Issued in MD

Practice address

28 Haddington Rd
Timonium, MD 21093-5719

Phone

(410) 961-0844

NPI assigned

May 13, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tariq Mahmood MD LLCGroup PAC ID 0042317042, 6 clinicians

M Medical Group, Inc.Group PAC ID 7719278597, shared by 2 NPIs, 104 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DHJFBA

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

• Tariq Mahmood, MD. LLC.

  • Internal Medicine Physician
  • Westminster, MD
  • NPI 1922178219
  Medicare reassignment Care Compare group NPD
• M Medical Group, Inc.

  • Internal Medicine Physician
  • Rising Sun, MD
  • NPI 1164238333
  Medicare reassignment NPD
• M Medical Group, Inc.

  • Critical Care Medicine (Internal Medicine) Physician
  • Clinton, MD
  • NPI 1780056168

  DC

  Medicare reassignment NPD
• Portal Health LLC

  • Health Service Clinic/Center
  • Baltimore, MD
  • NPI 1538964374
  NPD Authorized official
• M Medical Group, Inc.

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1447076203
  NPD

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1558749267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 HADDINGTON RD",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210935719",
            "telephone_number": "410-961-0844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 HADDINGTON RD",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210935719",
            "telephone_number": "410-961-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "ZELBESA",
        "middle_name": "VAILIIDA DAKUE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-13",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R137492",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R137492",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R137492",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Luthy, PA-C
• Luxottica of America Inc
• Lykos Pharmacy Inc
• Lynn R Chincheck, DDS
• Lauren Vincenza Macek, PSYCHOLOGY ASSOCIATE
• Dorrian Marnelle Maddox, LCSWC
• Mary Ellen Maenner, L.C.P.C.
• Lisa A Magarill-Hillman, DPTPHYSICAL THERAPIS
• Jennifer Lynn Magliano, CRNP
• Maria B Mainolfi - Palarata, MD

• Adult Health Nurse Practitioner in Timonium, MD
• Providers in Timonium, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.