Individual provider Active NPI

Molly E Warnock

  • Medical Physician Assistant
  • Annapolis, MD
National Provider Identifier
1821628751
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9113778 Issued in FL
Practice address
116 Defense Hwy Ste 102
Annapolis, MD 21401-7040
Phone
(888) 820-3376
NPI assigned
Jan 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MD
Medical Physician Assistant 363AM0700X PA9113778 FL Primary

Addresses

Primary practice location

116 Defense Hwy Ste 102
Annapolis, MD 21401-7040

Mailing address

16461 Domestic Ave
Fort Myers, FL 33912-6008
Phone (877) 266-7768

Other practice location 1

16461 Domestic Ave
Fort Myers, FL 33912-6008
Phone (877) 266-7768

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200325001425 MD Practitioner - Physician Assistant 2961830906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellave LLCGroup PAC ID 0648563015, 13 clinicians

Practice addresses (Care Compare)

116 Defense Hwy
Suite 102
Annapolis, MD 21401-7040
Phone (888) 820-3367

116 Defense Hwy
Suite 501
Annapolis, MD 21401-7063

1667 Crofton Ctr
Suite 5
Crofton, MD 21114-1303
Phone (888) 820-3376

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mollywarnock@onspotdermatology.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1821628751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16461 DOMESTIC AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339126008",
            "telephone_number": "877-266-7768",
            "fax_number": "603-952-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 DEFENSE HWY STE 102",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017040",
            "telephone_number": "888-820-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16461 Domestic Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339126008",
            "country_code": "US",
            "telephone_number": "877-266-7768",
            "fax_number": "603-952-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARNOCK",
        "first_name": "MOLLY",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9113778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.