Active NPI
Thomas J. Pasquarello, PA-C
- Physician Assistant
- Hagerstown, MD
National Provider Identifier
1083609465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C02125
- Practice address
- 17 Western Maryland Pkwy
Suite 100
Hagerstown, MD 21740-5471 - Phone
- (301) 797-9240
- Fax
- (301) 797-4234
- NPI assigned
- Sep 13, 2005
- Last updated
- May 14, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA001514L | PA | |
| Physician Assistant | 363A00000X | C02125 | MD | Primary |
| Medical Physician Assistant | 363AM0700X | MA001514L | PA |
Addresses
Primary practice location
17 Western Maryland Pkwy
Suite 100
Hagerstown, MD 21740-5471
Mailing address
3421 Concord Rd
York, PA 17402-9001
Phone (301) 797-9240
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA001514L | PA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellspan Medical Group | Current | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba WellSpan Digestive Health
- Gastroenterology Physician
- York, PA
- NPI 1669770004
-
dba WellSpan Medical Weight Management
- Obesity Medicine (Internal Medicine) Physician
- York, PA
- NPI 1114088408
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620950400000",
"number": "1083609465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3421 CONCORD RD",
"city": "YORK",
"state": "PA",
"postal_code": "174029001",
"telephone_number": "301-797-9240",
"fax_number": "301-797-4234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 WESTERN MARYLAND PKWY",
"address_2": "SUITE 100",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217405471",
"telephone_number": "301-797-9240",
"fax_number": "301-797-4234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASQUARELLO",
"first_name": "THOMAS",
"middle_name": "J.",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-13",
"last_updated": "2021-05-14",
"certification_date": "2021-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA001514L",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C02125",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA001514L",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hagerstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.