Individual provider Active NPI

Allison M. Moll, MD

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1639639859
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D94665 Issued in MD
Practice address
4660 Wilkens Ave Ste 100
Baltimore, MD 21229-4899
Phone
(410) 247-0782
NPI assigned
Mar 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D94665 MD Primary
Pediatrics Physician 208000000X 11912736-1205 UT

Addresses

Primary practice location

4660 Wilkens Ave Ste 100
Baltimore, MD 21229-4899

Mailing address

81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Phone (801) 662-5701

Other practice location 1

81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Phone (801) 662-5701

Other practice location 2

500 Upper Chesapeake Dr
Bel Air, MD 21014-4324
Phone (443) 643-1500

Other names 1

  • Allison M. Cool 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
I20220830003731 MD Practitioner - Pediatric Medicine 3375961923 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D94665MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jul 3, 2023 Accepting new patients
Upper Chesapeake Medical Services, Inc CurrentSince Aug 8, 2022 Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients

Locations

3007 Tilden St NW
Ste 5N
Washington, DC 20008

4660 Wilkens Ave
Ste 100
Baltimore, MD 21229
Phone (410) 247-0782

500 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (443) 643-1000

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

501 S Union Ave
Hvre de Grace, MD 21078
Phone (301) 939-2400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1639639859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131125",
            "telephone_number": "801-662-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 WILKENS AVE STE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212294899",
            "telephone_number": "410-247-0782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "81 N Mario Capecchi Dr",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841131125",
            "country_code": "US",
            "telephone_number": "801-662-5701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Upper Chesapeake Dr",
            "address_purpose": "LOCATION",
            "city": "Bel Air",
            "state": "MD",
            "postal_code": "210144324",
            "country_code": "US",
            "telephone_number": "443-643-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLL",
        "first_name": "ALLISON",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D94665",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "11912736-1205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "COOL",
            "middle_name": "M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.