Active NPI
Nicholas J Patronas, M.D.
- Neuroradiology Physician
- Hagerstown, MD
National Provider Identifier
1124008438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuroradiology Physician
- License
- D0027833
- Practice address
- 17 Western Maryland Pkwy
Suite 101
Hagerstown, MD 21740-5146 - Phone
- (301) 733-1477
- Fax
- (301) 733-7758
- NPI assigned
- Jan 20, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuroradiology Physician | 2085N0700X | D0027833 | MD | Primary |
| Diagnostic Radiology Physician | 2085R0202X | D0027833 | MD |
Addresses
Primary practice location
17 Western Maryland Pkwy
Suite 101
Hagerstown, MD 21740-5146
Mailing address
10729 Ardnave PL
Potomac, MD 20854-1261
Phone (703) 287-4189
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10117992 | Medicaid | VA | |
| 1804618000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0027833 | MD | MD | Neuroradiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Med Tel International Corporation | Past | Accepting new patients | |
| Med Tel International Corporation | Past | Accepting new patients | |
| Med Tel International Corporation | Past | Accepting new patients |
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.
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-
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- Milford, DE
- NPI 1821122573
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206576000000",
"number": "1124008438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10729 ARDNAVE PL",
"city": "POTOMAC",
"state": "MD",
"postal_code": "208541261",
"telephone_number": "703-287-4189",
"fax_number": "703-448-1807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 WESTERN MARYLAND PKWY",
"address_2": "SUITE 101",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217405146",
"telephone_number": "301-733-1477",
"fax_number": "301-733-7758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRONAS",
"first_name": "NICHOLAS",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-20",
"last_updated": "2008-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "MD",
"license": "D0027833",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MD",
"license": "D0027833",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10117992",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1804618000",
"state": "WV"
}
],
"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 Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.