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MAFOT & ASSOCIATES MEDICAL SERVICES LLC
NPI 1104248541
General Practice in Glen Burnie, MD

Active since January 18, 2014CLIA 21D2159075 · Waiver
1403 MADISON PARK DR STE 200, GLEN BURNIE, MD 21061(410) 487-6902(410) 487-6982 Get Directions Write a Review

NPPES record last updated: August 31, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mafot & Associates Medical Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAFOT & ASSOCIATES MEDICAL SERVICES LLC (NPI 1104248541) is a healthcare organization registered as a general practice in Glen Burnie, Maryland and active in the NPI registry since January 2014. The organization holds a CLIA Waiver certificate valid through December 11, 2026 and lists Dagobert Simo, Director, as its authorized official.

NPPES Registry Identity

NPI1104248541
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameMAFOT & ASSOCIATES MEDICAL SERVICES LLC
Location Address1403 MADISON PARK DR STE 200Glen Burnie, MD 21061-6427
Mailing Address11183 Columbia PikeSilver Spring, MD 20901-4507
Phone(410) 487-6902
Fax(410) 487-6982
Organization SubpartNo
Authorized OfficialDagobert SimoDirector · (240) 432-1924
Enumeration DateJanuary 18, 2014
Last NPPES UpdateAugust 31, 2022
NPPES CertifiedAugust 31, 2022
✔ NPI 1104248541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in MD · D0073466
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
1403 MADISON PARK DR STE 200, Glen Burnie, MD 21061
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2159075

Mafot & Associates Medical Services · Glen Burnie, MD
Active · expires Dec 11, 2026
CLIA Number21D2159075
Laboratory TypePhysician Office
Certificate Effective DateDecember 12, 2024
Certificate Expiration DateDecember 11, 2026
Laboratory DirectorDagobert Simo MD
Laboratory Phone(410) 487-6902
Laboratory LocationMafot & Associates Medical Services1403 Madison Park Drive Suite 200, Glen Burnie, MD 21061
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROLE K SIMO CRNP
Nurse Practitioner (Family)
1403 MADISON PARK DR STE 200
GLEN BURNIE, MD 21061
Anne Arundel County (410) 487-6902

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mafot & Associates Medical Services LLC's NPI number?

The NPI number for Mafot & Associates Medical Services LLC is 1104248541. It was assigned to this organization in the NPPES registry on January 18, 2014.

Where is Mafot & Associates Medical Services LLC located?

Mafot & Associates Medical Services LLC is located at 1403 Madison Park Dr Ste 200, Glen Burnie, MD 21061. The listed phone number is (410) 487-6902.

What is Mafot & Associates Medical Services LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Mafot & Associates Medical Services LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2159075) is associated with this NPI, valid through December 11, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mafot & Associates Medical Services LLC was last updated on August 31, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.