1St Medical of Annapolis, Inc.
Organization Active NPI Family Medicine Physician · Edgewater, MD
NPI 1922282425 · NPPES record last updated Dec 4, 2024
Key facts
- NPI
- 1922282425
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- 1ST MEDICAL OF ANNAPOLIS, INC.
- Practice address
- 20 Mayo Rd Ste 201
Edgewater, MD 21037-1442 - Phone
- (410) 956-6800
- Fax
- (410) 956-6803
- NPI assigned
- Dec 20, 2007
- Organization subpart
- No
Authorized official
- Name
- Rosemary Ingado, PA
- Title
- Clinical Administrator/Physician As
- Phone
- (410) 956-6800
Subparts reporting this organization as parent 8
Member organizations 1
Practitioners 14
-
Jacquelyn Paylor, CRNP
-
Perpetua Anthony, NP-C
-
Melissa Bassett, CRNP
-
Barbara A Denkins, CRNP
-
Irene A Ginczek, NP
-
Rosemary Ingado, P.A.
-
Nancy Dennisse Rivera, M.D.
-
Ann Marie Rustia, CRNP-F
-
Caroline Shirima, CRNP
-
Melissa May Bassett, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031223000759 | MD | Part B Supplier - Clinic/Group Practice | 6406754738 |
Receives reassigned benefits from 12 practitioners Practice locations: Edgewater, MD; Towson, MD; Oxon Hill, MD; Catonsville, MD |
National Provider Directory
Locations
75 Mayo Rd
Edgewater, MD 21037
Phone (410) 956-6800
831 University Blvd E
Ste 34AND36A
Silver Spring, MD 20903
Phone (301) 408-2720
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
20 Mayo Rd Ste 201
Edgewater, MD 21037-1442
Mailing address
20 Mayo Rd
Suite 201
Edgewater, MD 21037-1439
Phone (410) 956-6800
Other practice location 1
831 University Blvd E Ste 34And36A
Silver Spring, MD 20903-2916
Phone (301) 408-2720
Other practice location 2
405 Frederick Rd Ste 11
Catonsville, MD 21228-4607
Phone (410) 788-4411
Other practice location 3
7600 Osler Dr Ste 105
Towson, MD 21204-7705
Phone (410) 825-4500
Other practice location 4
5620 Saint Barnabas Rd Ste 340
Oxon Hill, MD 20745-3628
Phone (301) 747-4562
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 516301300 | Medicaid | MD |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Edgewater | Health Information Exchange (HIE) | 1ST MEDICAL PAIN MANAGEMENT SPECIALISTS |
Other providers in Edgewater, MD
- 1St Medical Pain Management Specialists
- 1St Medical Pain Management Specialists
- 1St Medical Pain Management Specialists
- 1St Medical Pain Management Specialists
- Sheri Ann Abell
All providers in Edgewater, MD · Family Medicine Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.