Individual provider Active NPI

Mara J Daidone, M.D.

  • Otolaryngology Physician
  • Prince Frederick, MD
National Provider Identifier
1841296407
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
D0055201 Issued in MD
Practice address
110 Hospital Rd
Suite 304
Prince Frederick, MD 20678-4019
Phone
(410) 535-4471
NPI assigned
Jun 28, 2005
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X D0055201 MD Primary

Addresses

Primary practice location

110 Hospital Rd
Suite 304
Prince Frederick, MD 20678-4019

Mailing address

100 Hospital Rd
Attn: Amy Grassey
Prince Frederick, MD 20678-4017
Phone (410) 414-4791

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0055201MDMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Calvert Health Ventures Inc Past Accepting new patients
American Surgical Associates LLC PastSince Jan 1, 2004 Accepting new patients
Medical & Surgical Clinics of Southern Maryland Inc Otolaryngology Past Accepting new patients

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, 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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1841296407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "address_2": "ATTN: AMY GRASSEY",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784017",
            "telephone_number": "410-414-4791",
            "fax_number": "410-414-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HOSPITAL RD",
            "address_2": "SUITE 304",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784019",
            "telephone_number": "410-535-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAIDONE",
        "first_name": "MARA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D0055201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.