Individual provider Active NPI

Idalee Wagman Digregorio, L.AC

  • Acupuncturist
  • Baltimore, MD
National Provider Identifier
1801172622
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
U01942 Issued in MD
Practice address
715 Park Ave
Baltimore, MD 21201-4711
Phone
(410) 454-0178
Fax
(443) 552-0319
NPI assigned
Oct 25, 2011
Last updated
Apr 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X U01942 MD Primary

Addresses

Primary practice location

715 Park Ave
Baltimore, MD 21201-4711

Mailing address

1804 Walnut Rd
Baltimore, MD 21209-3534
Phone (410) 454-0178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
U01942MDMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Satori Wellness and Acupuncture Center Acupuncturist Past Accepting new patients

Organizations & group practices 1

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": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1801172622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 WALNUT RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093534",
            "telephone_number": "410-454-0178",
            "fax_number": "443-552-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014711",
            "telephone_number": "410-454-0178",
            "fax_number": "443-552-0319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGREGORIO",
        "first_name": "IDALEE",
        "middle_name": "WAGMAN",
        "credential": "L.AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "U01942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.