NPIMap

Individual provider Active NPI

Archil Abashidze, MD

  • Psychiatry Physician
  • Glen Burnie, MD
National Provider Identifier
1891717757
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C1-0007963 Issued in DE
Practice address
7207 Baltimore Annapolis Blvd
Glen Burnie, MD 21061-2684
Phone
(410) 768-0123
Fax
(410) 768-1716
NPI assigned
Jul 23, 2006
Last updated
Oct 31, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X C1-0007963 DE Primary

Addresses

Primary practice location

7207 Baltimore Annapolis Blvd
Glen Burnie, MD 21061-2684

Mailing address

10C Queen Elizabeth CT
Chester, MD 21619-2544
Phone (443) 312-2099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091005000052 MD Practitioner - Psychiatry 1658327283 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Mississippi School of Medicine, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
People Encouraging People IncGroup PAC ID 3476518481, 5 clinicians
Interventions, LLCGroup PAC ID 9032426549, 4 clinicians

Practice addresses (Care Compare)

301 Hospital Dr
Glen Burnie, MD 21061-5803
Phone (410) 787-4000

313 Hospital Dr
Glen Burnie, MD 21061-5803
Phone (410) 761-1222

4201 Primrose Ave
Baltimore, MD 21215-3305
Phone (410) 764-8560

5 Oak CT
Annapolis, MD 21401-7017
Phone (410) 266-3040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C1-0007963DEMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
People Encouraging People, Inc. Current Accepting new patients
People Encouraging People, Inc. CurrentSince Feb 18, 2014 Accepting new patients
People Encouraging People, Inc. CurrentSince Feb 18, 2014 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Jan 1, 2016 Accepting new patients
University of Maryland Community Medical Group, Inc. Psychiatry CurrentSince Jan 1, 2016 Accepting new patients
Interventions, LLC CurrentSince Jul 4, 2015 Accepting new patients
State of Delaware Past Accepting new patients
Imperial Mentoring Past Accepting new patients
SW Ms Mental Health Mental Retardation Commission PastSince Jul 1, 2005 Accepting new patients
Southwest Mississippi Mental Health Mental Retardation Commission Past Accepting new patients
Imperial Mentoring Past Accepting new patients
Gulf Coast Mental Health Center PastSince Mar 7, 2020 Accepting new patients
Phoenix Behavioral Health Services Psychiatry Past Accepting new patients

Locations

5 Oak Ct
Annapolis, MD 21401
Phone (410) 266-3040

22 S Howard St
#1
Baltimore, MD 21201

4201 Primrose Ave
Baltimore, MD 21215
Phone (410) 764-8560

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

219 S Washington St
Easton, MD 21601

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

301 Hospital Dr
Fl 2
Glen Burnie, MD 21061
Phone (410) 787-4627

Interoperability endpoints

  • Direct secure messaging: aabashidze69226@direct.umm.edu

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1891717757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10C QUEEN ELIZABETH CT",
            "city": "CHESTER",
            "state": "MD",
            "postal_code": "216192544",
            "telephone_number": "443-312-2099",
            "fax_number": "410-768-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7207 BALTIMORE ANNAPOLIS BLVD",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210612684",
            "telephone_number": "410-768-0123",
            "fax_number": "410-768-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABASHIDZE",
        "first_name": "ARCHIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DE",
            "license": "C1-0007963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.