NPIMap

Individual provider Active NPI

Lisa Anne Marcinko, PAC

  • Physician Assistant
  • Perry Hall, MD
National Provider Identifier
1942521471
Registry record updated Jun 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0002272 Issued in MD
Practice address
9100 Rexis Ave
Perry Hall, MD 21128-9604
Phone
(410) 256-1443
NPI assigned
Jun 18, 2010
Last updated
Jun 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0002272 MD Primary

Addresses

Primary practice location

9100 Rexis Ave
Perry Hall, MD 21128-9604

Mailing address

9100 Rexis Ave
Perry Hall, MD 21128-9604
Phone (410) 256-1443

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
I20110928000535 MD Practitioner - Physician Assistant 4486825189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

5501 Hopkins Bayview Cir
Baltimore, MD 21224-6821
Phone (410) 550-0545

5505 Hopkins Bayview Cir
Baltimore, MD 21224-6821
Phone (410) 550-0756

6201 Greenleigh Ave
Middle River, MD 21220-2004

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0002272MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Oct 21, 2016 Accepting new patients
Johns Hopkins University CurrentSince Oct 21, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5505 Hopkins Bayview Cir
Baltimore, MD 21224
Phone (410) 550-0756

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

600 N Wolfe St
Baltimore, MD 21287

Interoperability endpoints

  • Direct secure messaging: lmarcinko35180@direct.hopkinsmedicine.org

Organizations & group practices 4

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.

Hospital & facility affiliations 10

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": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276819200000",
    "number": "1942521471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 REXIS AVE",
            "city": "PERRY HALL",
            "state": "MD",
            "postal_code": "211289604",
            "telephone_number": "410-256-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 REXIS AVE",
            "city": "PERRY HALL",
            "state": "MD",
            "postal_code": "211289604",
            "telephone_number": "410-256-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCINKO",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2010-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry Hall, MD

Sources for this page

Verify at the official NPI Registry.