NPIMap

Organization Active NPI

Montgomery General Hospital, Inc.

  • General Acute Care Hospital
  • Olney, MD
National Provider Identifier
1114922341
Registry record updated Oct 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
15-202 Issued in MD
Legal business name
MONTGOMERY GENERAL HOSPITAL, INC.
Practice address
18101 Prince Philip Dr
Olney, MD 20832-1514
Phone
(301) 774-8649
Fax
(301) 774-9676
NPI assigned
Jun 15, 2005
Last updated
Oct 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2026

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

Authorized official

Name
Mr. John Hogarty
Title
Sr. Vice President/ Cfo
Phone
(301) 774-8649

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 15-202 MD Primary

Addresses

Primary practice location

18101 Prince Philip Dr
Olney, MD 20832-1514

Mailing address

18101 Prince Philip Dr
Olney, MD 20832-1514

Other identifiers 13

IdentifierTypeStateIssuer
45833OtherMDAMERICAID MCO
235094OtherMDUFCW/FELRA
5000047OtherMDUNITED HEALTHCARE
9992OtherMDAETNA
OOO315800OtherMDMAPS MD
000315800MedicaidMD
4235094OtherMDMDIPA
104272OtherMHKAISER
5000047OtherMDUNITED HEALTH MCO
57355901OtherMDCAREFIRST OF MD
734OtherMDBCBS NATIONAL ACCOUNTS
O20719200OtherDCDC MEDICAID
234094OtherMDALLIANCE PPO

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071126000444 MD Part A Provider - Hospital 1254315419 Practice locations: Olney, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114922341. Details of each certification follow.

Hospital certification: CCN 210018

Legal name
MONTGOMERY GENERAL HOSPITAL INC
Doing business as
MEDSTAR MONTGOMERY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 27, 2010
Beds
165
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jun 11, 1918 in MD
Enrollment address
18101 Prince Philip Dr
Olney, MD 20832-1514
Other Hospital Practice Location
Hospital subgroups
Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Medstar Montgomery Medical CenterCCN 210018 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
21D0212005Medstar Montgomery Medical Center Laboratory18101 Prince Philip Drive, Olney, MD 20832AccreditationFeb 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
MGH Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Carolina Chavarria Individual Corporate OfficerSecretary Mar 2, 2016
Montgomery General Hospital Inc Organization, Olney, MD Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 1, 2008 100%
Deborah Ellinghaus Individual Corporate DirectorBoard Member Nov 1, 2016
David Havrilla Individual Corporate OfficerTreasurer Jul 1, 2009
W-2 Managing EmployeeCfo/VP of Finance Jul 1, 2009
Operational/Managerial ControlCfo/VP of Finance Jul 1, 2009
Steven Marc Shimoura Individual Corporate DirectorBoard Member Nov 1, 2014
Alok Mathur Individual Corporate DirectorBoard Member Nov 1, 2014
Thomas J. Senker Individual Corporate OfficerPresident Mar 1, 2016
Corporate DirectorBoard Member Mar 1, 2016
W-2 Managing EmployeePresident Mar 1, 2016
Operational/Managerial ControlPresident Mar 1, 2016
Tasha Cerjanic Individual W-2 Managing EmployeeDirector of Finance Aug 16, 2021
Marc L Kozam Individual Corporate DirectorBoard Member Nov 1, 2018
Kenneth a Samet Individual Corporate DirectorBoard Member Feb 1, 2008
Neil Roy Ohora Individual Corporate DirectorBoard Member Nov 1, 2018
Richard Hoffman Individual Corporate DirectorBoard Member Nov 1, 2017
John Ferguson Individual Corporate DirectorBoard Member Nov 1, 2009
Gary Fernandes Individual Corporate DirectorBoard Member Nov 1, 2018
Katherine Farquhar Individual Corporate DirectorBoard Member Nov 1, 2012
Richard Weinstein Individual Corporate DirectorBoard Member Nov 1, 2011
Sujithra Jayaraj-Sudarsan Individual Corporate DirectorBoard Member Nov 1, 2015
Christine Hill Wilson Individual Corporate DirectorBoard Member Dec 1, 2020
Medstar Health, Inc. Organization, Columbia, MD Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2008 100%

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 13

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 13

Practitioners & affiliated clinicians

Practitioners 40

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.

View all 40

Affiliated clinicians 392

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 392

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792108800000",
    "number": "1114922341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18101 PRINCE PHILIP DR",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321514",
            "fax_number": "301-774-9676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 PRINCE PHILIP DR",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321514",
            "telephone_number": "301-774-8649",
            "fax_number": "301-774-9676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY GENERAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A",
        "authorized_official_last_name": "HOGARTY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT/ CFO",
        "authorized_official_telephone_number": "301-774-8649",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MD",
            "license": "15-202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAID MCO",
            "identifier": "45833",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UFCW/FELRA",
            "identifier": "235094",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "5000047",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9992",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAPS MD",
            "identifier": "OOO315800",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000315800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDIPA",
            "identifier": "4235094",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "104272",
            "state": "MH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH MCO",
            "identifier": "5000047",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF MD",
            "identifier": "57355901",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NATIONAL ACCOUNTS",
            "identifier": "734",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC MEDICAID",
            "identifier": "O20719200",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE PPO",
            "identifier": "234094",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

Verify at the official NPI Registry.