| Mdics Rehabilitative Services - Ltcaco LLC | |
|
121 Morris Dr La Plata MD 20646-4254 | |
| (410) 999-1133 | |
| Not Available |
| Full Name | Mdics Rehabilitative Services - Ltcaco LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 121 Morris Dr, La Plata, Maryland |
| Authorized Official Name and Position | David Sweatt (CFO) |
| Authorized Official Contact | 2408418714 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mdics Rehabilitative Services - Ltcaco LLC Po Box 69231 Baltimore MD 21264-9231 | Mdics Rehabilitative Services - Ltcaco LLC 121 Morris Dr La Plata MD 20646-4254 Ph: (410) 999-1133 |
| NPI Number | 1033005475 |
|---|---|
| Provider Enumeration Date | 06/13/2025 |
| Last Update Date | 06/13/2025 |
| Certification Date | 06/13/2025 |
| Medicare PECOS PAC ID | 8426556267 |
|---|---|
| Medicare Enrollment ID | O20250811001940 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033005475 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Ellen R Mcinerney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235176157 PECOS PAC ID: 8527951144 Enrollment ID: I20040205001267 |
| Provider Name | Muhammad a Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568575074 PECOS PAC ID: 6800814559 Enrollment ID: I20051110000695 |
| Provider Name | Juachi I Mbah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659326411 PECOS PAC ID: 0345245759 Enrollment ID: I20060918000505 |
| Provider Name | Edith Aniedobe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467641183 PECOS PAC ID: 5890834048 Enrollment ID: I20091201000018 |
| Provider Name | Amare Abebe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629109970 PECOS PAC ID: 3678606100 Enrollment ID: I20100804000064 |
| Provider Name | Summit Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942485321 PECOS PAC ID: 6406931674 Enrollment ID: I20110107000257 |
| Provider Name | Hung T Davis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669446548 PECOS PAC ID: 8224039482 Enrollment ID: I20110323000481 |
| Provider Name | Kirandeep Kaur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073742102 PECOS PAC ID: 1153445143 Enrollment ID: I20110324000472 |
| Provider Name | Josjin Vazhappilly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851520936 PECOS PAC ID: 8820283583 Enrollment ID: I20110324000498 |
| Provider Name | Patricia Oshodi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558516187 PECOS PAC ID: 9133250624 Enrollment ID: I20110616000521 |
| Provider Name | Jose G Martinez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417907858 PECOS PAC ID: 6608861778 Enrollment ID: I20120120000542 |
| Provider Name | Erin M Mcenany |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710138102 PECOS PAC ID: 3476612581 Enrollment ID: I20120203000258 |
| Provider Name | Stephanie a Joy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134425028 PECOS PAC ID: 0042495244 Enrollment ID: I20120307000024 |
| Provider Name | Carrie a Dana-evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548536675 PECOS PAC ID: 4183887540 Enrollment ID: I20120531000378 |
| Provider Name | Addisu M Temesgen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386971927 PECOS PAC ID: 4183812266 Enrollment ID: I20120625000642 |
| Provider Name | Michael J Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710245220 PECOS PAC ID: 9032374814 Enrollment ID: I20120629000017 |
| Provider Name | Warren Clifton Mccormick |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609127547 PECOS PAC ID: 7618129743 Enrollment ID: I20130104000407 |
| Provider Name | Karen Ann Cousins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912921453 PECOS PAC ID: 1456381474 Enrollment ID: I20130130000377 |
| Provider Name | Suela Kaba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730383571 PECOS PAC ID: 1557558814 Enrollment ID: I20130228000205 |
| Provider Name | Arnulfo B Bonavente |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619973534 PECOS PAC ID: 7517154982 Enrollment ID: I20130424000034 |
| Provider Name | Farida Amer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467685586 PECOS PAC ID: 3072757418 Enrollment ID: I20131007000248 |
| Provider Name | Ali M Yahya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013934181 PECOS PAC ID: 8022141803 Enrollment ID: I20131115000013 |
| Provider Name | Laurie B Gezelle |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245429000 PECOS PAC ID: 2264514512 Enrollment ID: I20140509001004 |
| Provider Name | Jennifer R Knode |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245237684 PECOS PAC ID: 5698890168 Enrollment ID: I20141030001145 |
| Provider Name | Megan N Shroyer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063726313 PECOS PAC ID: 5799979563 Enrollment ID: I20150513002136 |
| Provider Name | Yesha S Patel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871870535 PECOS PAC ID: 0749456739 Enrollment ID: I20150514001676 |
| Provider Name | Jameka W Riley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1073794491 PECOS PAC ID: 9335224153 Enrollment ID: I20150527000206 |
| Provider Name | Bridgette a Gillin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366815698 PECOS PAC ID: 2365744299 Enrollment ID: I20160108000686 |
| Provider Name | Virginia Noftsier |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598028649 PECOS PAC ID: 4284881053 Enrollment ID: I20160302000043 |
| Provider Name | Shahana Karim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275591141 PECOS PAC ID: 6800067083 Enrollment ID: I20160713000341 |
| Provider Name | Virginie Chebou Ngantchon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194764514 PECOS PAC ID: 9436176609 Enrollment ID: I20170324001255 |
| Provider Name | Tejaswi Reddy Vootla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164780011 PECOS PAC ID: 1153605506 Enrollment ID: I20170622002151 |
| Provider Name | Karen Vancamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003272840 PECOS PAC ID: 3375847155 Enrollment ID: I20170921000624 |
| Provider Name | Chase Neitzke |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730552118 PECOS PAC ID: 5799089017 Enrollment ID: I20180312000125 |
| Provider Name | Carla Schell Bowling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013439561 PECOS PAC ID: 9133493216 Enrollment ID: I20180917000311 |
| Provider Name | Johanna Devine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801377304 PECOS PAC ID: 2668717380 Enrollment ID: I20181227000068 |
| Provider Name | Bibi Aysha Siddhika |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720264658 PECOS PAC ID: 9739467226 Enrollment ID: I20190729001054 |
| Provider Name | Seid Aminu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215334602 PECOS PAC ID: 3173815388 Enrollment ID: I20190821004486 |
| Provider Name | Kuroush Aligholizadeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144734492 PECOS PAC ID: 2860754470 Enrollment ID: I20191029002663 |
| Provider Name | Katherine E Daugherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912464819 PECOS PAC ID: 4486997988 Enrollment ID: I20191219000508 |
| Provider Name | Kwabena Asante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235602905 PECOS PAC ID: 6305175100 Enrollment ID: I20200225000262 |
| Provider Name | Soukeye Niang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881159093 PECOS PAC ID: 6406287358 Enrollment ID: I20200511001063 |
| Provider Name | Cynthia Safo-mensa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164011698 PECOS PAC ID: 6608283601 Enrollment ID: I20210318000049 |
| Provider Name | Solange Bih |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669736237 PECOS PAC ID: 2365832417 Enrollment ID: I20211203000007 |
| Provider Name | Holly Nilsson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295408581 PECOS PAC ID: 8628475670 Enrollment ID: I20220308000994 |
| Provider Name | Melissa Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750730222 PECOS PAC ID: 7618263021 Enrollment ID: I20220520000131 |
| Provider Name | Ashok Kumar Ahuja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508048778 PECOS PAC ID: 7113312356 Enrollment ID: I20220714004228 |
| Provider Name | Cyriac Nchang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427589878 PECOS PAC ID: 1254750193 Enrollment ID: I20221019001307 |
| Provider Name | Yuhana Gidey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861109373 PECOS PAC ID: 9234502832 Enrollment ID: I20230301002820 |
| Provider Name | Jacqueline Ryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851360192 PECOS PAC ID: 8224222039 Enrollment ID: I20230907002367 |
| Provider Name | Yolanda Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528641560 PECOS PAC ID: 7012363773 Enrollment ID: I20231101000703 |
| Provider Name | Sabrina Ngong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851854244 PECOS PAC ID: 7012241854 Enrollment ID: I20240318001479 |
| Provider Name | Suzette Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386258929 PECOS PAC ID: 5597135418 Enrollment ID: I20240509001703 |
| Provider Name | Kimberly a Longo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356091888 PECOS PAC ID: 4183009772 Enrollment ID: I20240621001773 |
| Provider Name | Cynthia Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861249211 PECOS PAC ID: 1456882067 Enrollment ID: I20241008000523 |
| Provider Name | Michelle Leigh Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184456691 PECOS PAC ID: 9335671361 Enrollment ID: I20241016001015 |
| Provider Name | Malcolm Winkle |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1629574173 PECOS PAC ID: 1658733225 Enrollment ID: I20241212002300 |
| Provider Name | Emnet Yibeltal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952980245 PECOS PAC ID: 6204374945 Enrollment ID: I20250113001004 |
| Provider Name | Julie Kramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689469512 PECOS PAC ID: 6305364316 Enrollment ID: I20250527000070 |
| Provider Name | Olamide Odetoye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306557830 PECOS PAC ID: 0446618557 Enrollment ID: I20250708000286 |
| Provider Name | Holland Laurin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871753202 PECOS PAC ID: 2860559606 Enrollment ID: I20251008004436 |
| Provider Name | Linda Dennis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437674850 PECOS PAC ID: 0749546265 Enrollment ID: I20251126002529 |
| Provider Name | Victoria Oluwaseun Spencer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093009748 PECOS PAC ID: 0042530586 Enrollment ID: I20251231001010 |
| Provider Name | Randi Nicole Bouchillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437888138 PECOS PAC ID: 5092299792 Enrollment ID: I20260320001095 |
| Provider Name | Kimberly Fern |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245535749 PECOS PAC ID: 1254507965 Enrollment ID: I20260527002533 |
University of Maryland Community Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 North La Plata Court, Suite 202, La Plata, MD 20646 Phone: 301-609-4276 |
Mdics Rehabilitative Services - Ltcaco LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10210 Laplata Rd, La Plata, MD 20646 Phone: 301-392-3007 |
University of Maryland Community Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 616 East Charles Street, Suite 102, La Plata, MD 20646 Phone: 301-609-5445 |
Charelne A. Letchford MD PA Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 La Grange Ave, Suite 101, La Plata, MD 20646 Phone: 301-392-1935 Fax: 301-392-1936 |
University of Maryland Community Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 North La Plata Court Ste 103, La Plata, MD 20646 Phone: 301-609-5380 |
Mdics Rehabilitative Services LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10200 Laplata Rd, La Plata, MD 20646 Phone: 301-934-1900 |