Individual provider Active NPI

Nicholas J Patronas, M.D.

  • Neuroradiology Physician
  • Hagerstown, MD
National Provider Identifier
1124008438
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
D0027833 Issued in MD
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

Updated by the provider on Mar 27, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
10117992MedicaidVA
1804618000MedicaidWV

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

LicenseStateTypeSpecialty
D0027833MDMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.