Organization Active NPI

Richard D. Maffezzoli LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Towson, MD
National Provider Identifier
1871775981
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
DO7132 Issued in MD
Legal business name
RICHARD D. MAFFEZZOLI LLC
Practice address
515 Fairmount Ave
Suite 330
Towson, MD 21286-5466
Phone
(410) 494-1213
Fax
(410) 494-1233
NPI assigned
Nov 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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

Authorized official

Name
Dr. Richard D Maffezzoli, M.D.NPI 1669438214
Title
Sole Priopritor
Phone
(410) 494-1213

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
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X DO7132 MD Primary

Addresses

Primary practice location

515 Fairmount Ave
Suite 330
Towson, MD 21286-5466

Mailing address

19 Seminary Dr
Lutherville, MD 21093-4757
Phone (410) 494-1213

Other identifiers 1

IdentifierTypeStateIssuer
025571800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080227000128 MD Part B Supplier - Clinic/Group Practice 7113001314 Receives reassigned benefits from 1 practitioner
Practice locations: Towson, MD

National Provider Directory

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": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303171200000",
    "number": "1871775981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 SEMINARY DR",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210934757",
            "telephone_number": "410-494-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 FAIRMOUNT AVE",
            "address_2": "SUITE 330",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865466",
            "telephone_number": "410-494-1213",
            "fax_number": "410-494-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD D. MAFFEZZOLI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2011-04-19",
        "status": "A",
        "authorized_official_last_name": "MAFFEZZOLI",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SOLE PRIOPRITOR",
        "authorized_official_telephone_number": "410-494-1213",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MD",
            "license": "DO7132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025571800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.