Individual provider Active NPI

Mandy Nicole Fawcett, PA-C,

  • Physician Assistant
  • Catonsville, MD
National Provider Identifier
1669929451
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C06237 Issued in MD
Practice address
910 Frederick Rd
Catonsville, MD 21228-4516
Phone
(410) 644-1880
Fax
(410) 646-3623
NPI assigned
Sep 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C06237 MD Primary

Addresses

Primary practice location

910 Frederick Rd
Catonsville, MD 21228-4516

Mailing address

910 Frederick Rd
Catonsville, MD 21228-4516
Phone (410) 644-1880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161215000915 MD Practitioner - Physician Assistant 5395025068 Reassigns benefits to 3 organizations
I20161215001007 DC Practitioner - Physician Assistant 5395025068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
86.7
Promoting interoperability
100
Improvement activities
40
Cost
73.06

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince Nov 1, 2016 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Nov 14, 2022 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jun 1, 2022 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Nov 14, 2022 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Apr 1, 2020 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Apr 1, 2020 Accepting new patients
Orthopaedic Associates of Central Maryland, PA Past Accepting new patients

Locations

201 Defense Hwy
Ste 150
Annapolis, MD 21401

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

2000 Medical Pkwy
Ste 101
Annapolis, MD 21401
Phone (410) 295-8900

15500 Annapolis Rd
Ste 102
Bowie, MD 20715
Phone (301) 805-0190

4175 N Hanson Ct
Ste 201
Bowie, MD 20716
Phone (443) 481-1199

910 Frederick Rd
Catonsville, MD 21228

1630 Main St
Ste 213
Chester, MD 21619
Phone (443) 481-5300

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

6300 Georgetown Blvd
Ste 139
Sykesville, MD 21784

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11237/brand/1/csg/1/fhir/r4
  • Direct secure messaging: 17mfawcett@cfaortho.emadirect.md
  • Direct secure messaging: mfawcett45281@direct.aahs.org

Organizations & group practices 10

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": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1669929451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 FREDERICK RD",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284516",
            "telephone_number": "410-644-1880",
            "fax_number": "410-646-3623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 FREDERICK RD",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284516",
            "telephone_number": "410-644-1880",
            "fax_number": "410-646-3623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWCETT",
        "first_name": "MANDY",
        "middle_name": "NICOLE",
        "credential": "PA-C,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C06237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Catonsville, MD

Sources for this page

Verify at the official NPI Registry.