Organization Active NPI

Carroll Family Medicine, LLC

  • Family Medicine Physician
  • Hampstead, MD
National Provider Identifier
1043240708
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CARROLL FAMILY MEDICINE, LLC
Practice address
814 Houcksville Rd
Hampstead, MD 21074-1882
Phone
(410) 239-0406
Fax
(410) 239-0407
NPI assigned
Jul 5, 2006
Last updated
Mar 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Authorized official

Name
Dr. Peter G Uggowitzer, M.D.NPI 1255333274
Title
President/Owner
Phone
(410) 239-0406

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

814 Houcksville Rd
Hampstead, MD 21074-1882

Mailing address

814 Houcksville Rd
Hampstead, MD 21074-1882
Phone (410) 239-0406

Other identifiers 9

IdentifierTypeStateIssuer
0877346OtherMDAETNA US HEALTHCARE
11071OtherMDPREFERRED HEALTH NETWORK
CN 7035OtherMDRAILROAD MEDICARE
745191100MedicaidMD
KC91CAOtherMDBC/BS PAR/PPN/POS
MAMSIOtherMD250778
E289OtherMDBC/BS FED/BLUE CHOICE
10112104OtherMDCIGNA
4508793OtherMDAETNA MC/PPO/EPO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050428000797 MD Part B Supplier - Clinic/Group Practice 8022057082 Receives reassigned benefits from 4 practitioners
Practice locations: Hampstead, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0937433Carroll Family Medicine LLC814 N Houcksville Road, Hampstead, MD 21074Provider-performed microscopyDec 15, 2027

National Provider Directory

National Provider Directory

Locations

4500 Black Rock Rd
Hampstead, MD 21074
Phone (410) 239-0406

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1043240708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 HOUCKSVILLE RD",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210741882",
            "telephone_number": "410-239-0406",
            "fax_number": "410-239-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 HOUCKSVILLE RD",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210741882",
            "telephone_number": "410-239-0406",
            "fax_number": "410-239-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLL FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "UGGOWITZER",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "410-239-0406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "0877346",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH NETWORK",
            "identifier": "11071",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN 7035",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "745191100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PAR/PPN/POS",
            "identifier": "KC91CA",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "250778",
            "identifier": "MAMSI",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS FED/BLUE CHOICE",
            "identifier": "E289",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "10112104",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA MC/PPO/EPO",
            "identifier": "4508793",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampstead, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.