Walnut Street Community Health Center, Inc.
A Medicare group practice based in Hagerstown, MD: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 6305757402), with 23 clinicians.
Medicare enrollment
Medicare enrollment files- PAC ID
- 6305757402
- Provider type
- Part A Provider - Federally Qualified Health Center (FQHC), Part B Supplier - Clinic/Group Practice, Part B Supplier - Mass Immunization (Roster Biller Only)
- Enrolled in
- MD
- Enrollments
- 3
- Group size
- 18 clinicians
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Practice locations
- 4
Enrollment records 3
| Enrollment ID | State | Provider type | NPI |
|---|---|---|---|
| O20030922000032 | MD | Part A Provider - Federally Qualified Health Center (FQHC) | 1366425266 |
| O20040614001534 | MD | Part B Supplier - Clinic/Group Practice | 1366425266 |
| O20230428000460 | MD | Part B Supplier - Mass Immunization (Roster Biller Only) | 1871234294 |
NPIs in this group 2
NPPES NPI RegistryThese NPI records belong to the same enrolled organization. Each has its own page.
-
Walnut Street Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Hagerstown, MD
- NPI 1366425266
-
Walnut Street Community Health Center, Inc.
- Community/Retail Pharmacy
- Hagerstown, MD
- NPI 1871234294
Practice locations
- Hagerstown, MD4
Clinicians 23
Clinicians who reassign their Medicare benefits to this group (23) or whom Care Compare lists as members (18).
-
Festus Addo Agyekum, PA-C
- Physician Assistant
- Frederick, MD
- NPI 1508070913
-
Susan Jane Boyd, MD
- Psychiatry Physician
- Hagerstown, MD
- NPI 1164431516
-
Camille Ava Loanzon Canlas, CRNP
- Family Nurse Practitioner
- Columbia, MD
- NPI 1659658052
-
Michael Cochran, DNP, FNP-C
- Family Nurse Practitioner
- Hagerstown, MD
- NPI 1861171381
-
Elizabeth N Domanski, M.S. LCPC
- Mental Health Counselor
- Hagerstown, MD
- NPI 1336372754
-
Rachelle Long Fischer, FNP
- Family Nurse Practitioner
- Rolla, ND
- NPI 1215414099
-
Erin Leigh Foutch
- Family Nurse Practitioner
- Hagerstown, MD
- NPI 1982160347
-
Rocky Dominic Gallamoza, CRNP
- Family Nurse Practitioner
- Frederick, MD
- NPI 1487248548
-
Robin Diane Gipe, LCPC
- Professional Counselor
- Hagerstown, MD
- NPI 1972016772
-
Angela House, LMSW
- Clinical Social Worker
- Hagerstown, MD
- NPI 1659926400
-
Gnanaraj Johnson Koilpillai, M.D.
- Family Medicine Physician
- Frederick, MD
- NPI 1245218064
-
Sharon Rose Marren, LCSW-C
- Clinical Social Worker
- Hagerstown, MD
- NPI 1235799206
-
Stephanie Ann-Fogle McMillan, FNP-C
- Family Nurse Practitioner
- Hagerstown, MD
- NPI 1275387623
-
Tamara Medina
- Psychiatric/Mental Health Nurse Practitioner
- Hagerstown, MD
- NPI 1295138071
-
Mekedes Mekonnen, CRNP-PMH
- Psychiatric/Mental Health Nurse Practitioner
- Laurel, MD
- NPI 1174230858
-
Natsai Mutokuto, NP
- Family Nurse Practitioner
- Gaithersburg, MD
- NPI 1700613577
-
Martha Ann Pendleton-Riggle, MD
- Family Medicine Physician
- Hagerstown, MD
- NPI 1306829205
-
Melissa Ann Phillips, LCSW-C
- Clinical Social Worker
- Boonsboro, MD
- NPI 1023164829
-
Daniel Christopher Rosko, PA-C
- Medical Physician Assistant
- Frederick, MD
- NPI 1154686392
-
Karin Socks
- Addiction (Substance Use Disorder) Counselor
- Hagerstown, MD
- NPI 1659986180
-
Katherine Gruber Wafer, CRNP
- Family Nurse Practitioner
- Hagerstown, MD
- NPI 1164617379
-
Susan M Womeldorf, MD
- Family Medicine Physician
- Hagerstown, MD
- NPI 1336211796
-
William Edward Daniel Yeaman, D.P.M.
- Foot & Ankle Surgery Podiatrist
- Hagerstown, MD
- NPI 1780808238
Sources for this page
- Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
- Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
- NPPES NPI Registry: the names and addresses of the NPIs above.