Organization Active NPI

Pediatric Endocrinology of Annapolis

  • Pediatric Endocrinology Physician
  • Salisbury, MD
National Provider Identifier
1780438457
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
Legal business name
PEDIATRIC ENDOCRINOLOGY OF ANNAPOLIS
Practice address
560 Riverside Dr Ste B102
Salisbury, MD 21801-4701
Phone
(443) 203-8202
Fax
(443) 203-8601
NPI assigned
Apr 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Authorized official

Name
Melissa I Pagan Pares, MDNPI 1902178023
Title
Owner
Phone
(443) 203-8202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0205X Primary

Addresses

Primary practice location

560 Riverside Dr Ste B102
Salisbury, MD 21801-4701

Mailing address

2024 West St Ste 304
Annapolis, MD 21401-3556
Phone (443) 203-8202

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2216033Pediatric Endocrinology of Annapolis560 Riverside Drive #B102, Salisbury, MD 21801Certificate of waiverMar 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Endocrinology of Annapolis2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1780438457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 WEST ST STE 304",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013556",
            "telephone_number": "443-203-8202",
            "fax_number": "443-203-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 RIVERSIDE DR STE B102",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218014701",
            "telephone_number": "443-203-8202",
            "fax_number": "443-203-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ENDOCRINOLOGY OF ANNAPOLIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "PAGAN PARES",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-203-8202",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.