Individual provider Active NPI

Roy Degrange Jr.

  • Certified Registered Nurse Anesthetist
  • Frederick, MD
National Provider Identifier
1053942284
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R204452 Issued in MD
Practice address
400 W 7TH St
Frederick, MD 21701-4506
Phone
(250) 566-3300
NPI assigned
Jan 27, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R204452 MD
Certified Registered Nurse Anesthetist 367500000X R204452 MD Primary

Addresses

Primary practice location

400 W 7TH St
Frederick, MD 21701-4506

Mailing address

6215 Margarita Way
Frederick, MD 21703-2894
Phone (301) 471-8912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200812001123 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133545833 Reassigns benefits to 1 organization
I20200812001323 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133545833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Company LLCGroup PAC ID 4587559026, 373 clinicians

Practice addresses (Care Compare)

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 566-3300

70 Sherry LN
Suite 101
Prince Frederick, MD 20678-3276
Phone (410) 889-2040

Hospital & facility affiliations

  • Frederick Health Hospital Hospital, Frederick, MD, CCN 210005

Merit-based Incentive Payment System (MIPS)

Final score
63.85 of 100Reported as group
Quality
57.47
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Company, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 19, 2025 Accepting new patients
First Colonies Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 21, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

70 Sherry Ln
Ste 101
Prnc Frederck, MD 20678
Phone (410) 889-2040

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

11210 Old Georgetown Rd
Rockville, MD 20852
Phone (301) 881-7770

11210 Old Georgetown Rd
#12202
Rockville, MD 20852
Phone (301) 881-7770

8322 Bellona Ave
Ste 201
Towson, MD 21204
Phone (410) 337-2688

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1053942284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6215 MARGARITA WAY",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217032894",
            "telephone_number": "301-471-8912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506",
            "telephone_number": "250-566-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRANGE",
        "first_name": "ROY",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R204452",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R204452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; 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.