Cicely Monique Pickett, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

D61821 Issued in MD

Practice address

1701 Twin Springs Rd
Halethorpe, MD 21227-3553

Phone

(800) 777-7904

NPI assigned

Jun 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Halethorpe, MD
  • NPI 1043378656

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Baltimore Washington Medical Center Inc.

  • General Acute Care Hospital
  • Glen Burnie, MD
  • NPI 1124016696
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Luminis Health Anne Arundel Medical Center, Inc.

  • General Acute Care Hospital
  • Annapolis, MD
  • NPI 1477517225
  NPD (past)

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1932105145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PUMPHREY FARM DR",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081485",
            "telephone_number": "410-299-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 TWIN SPRINGS RD",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "212273553",
            "telephone_number": "800-777-7904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "CICELY",
        "middle_name": "MONIQUE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D61821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376751500",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST-DC",
            "identifier": "0038",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST-MD",
            "identifier": "642258-02",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggat",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1701 Twin Springs Rd",
            "city": "Halethorpe",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212273553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Minesh Ranchhodbhai Patel, M.D.
• Shreyas Patel, M.D.
• Yash Alpesh Patel, MD
• Pay It Forward Behavioral Health Center LLC
• Jennifer Edith Pertofsky-Plotnek, LCSW-C
• Caroline Poff, PMHNP
• Dawn Marie Presley, CMT
• Priority Care Primary Care Clinics
• Ibrahim Qazi, PHARMD
• Qumolz Healthcare Inc

• Obstetrics & Gynecology Physician in Halethorpe, MD
• Providers in Halethorpe, MD by specialty
• Obstetrics & Gynecology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.