Individual provider Active NPI

Michael Mardiney III, M.D.

  • Allergy & Immunology Physician
  • Ellicott City, MD
National Provider Identifier
1609827724
Registry record updated Aug 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
D0043585 Issued in MD
Practice address
3105 N Ridge Rd
Ellicott City, MD 21043-3348
Phone
(410) 461-7660
Fax
(410) 461-2853
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X D0043585 MD Primary

Addresses

Primary practice location

3105 N Ridge Rd
Ellicott City, MD 21043-3348

Mailing address

PO Box 609
Ellicott City, MD 21041-0609
Phone (410) 461-4500

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
I20051213000380 MD Practitioner - Allergy/Immunology 7012951189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Georgetown University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3105 N Ridge Rd
Ellicott City, MD 21043-3348
Phone (410) 461-7660

Merit-based Incentive Payment System (MIPS)

Final score
78.81 of 100Reported as individual
Quality
71.67
Improvement activities
40
Cost
67.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0043585MDMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501545600000",
    "number": "1609827724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210410609",
            "telephone_number": "410-461-4500",
            "fax_number": "410-461-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 N RIDGE RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433348",
            "telephone_number": "410-461-7660",
            "fax_number": "410-461-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDINEY",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2017-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MD",
            "license": "D0043585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.