NPIMap

Individual provider Active NPI

Nilay Bhasker Thaker, D.O.

  • Adult Medicine Physician
  • Martinsburg, WV
National Provider Identifier
1124275334
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
OS022728 Issued in PA
Practice address
484 Williamsport Pike # 151
Martinsburg, WV 25404-5707
Phone
(630) 730-0302
NPI assigned
Aug 20, 2008
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X OS022728 PA Primary
Adult Medicine Physician 207QA0505X 3634 WV

Addresses

Primary practice location

484 Williamsport Pike # 151
Martinsburg, WV 25404-5707

Mailing address

6030 Daybreak Circle
Suite A150 PMB 263
Clarksville, MD 21029-1638
Phone (630) 730-0302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, WV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101007000466 MD Practitioner - Family PracticePractitioner - Geriatric Medicine 5395869861 Reassigns benefits to 1 organization
I20210630002337 WV Practitioner - Family Practice 5395869861 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PA Post Acute Services PCGroup PAC ID 7911374905, 35 clinicians

Practice addresses (Care Compare)

100 Heartland Dr
Beckley, WV 25801-2655
Phone (513) 489-7100

1263 S George St
Charles Town, WV 25414-4384
Phone (304) 725-6575

183 Holbrook Rd
Buckhannon, WV 26201-0029
Phone (513) 489-7100

456 Autumn Acres Rd
Berkeley Springs, WV 25411-3202
Phone (513) 489-7100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3634WVMDGeneral Practice Dentistry
OS022728PAMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PA Post Acute Services PC CurrentSince Dec 28, 2024 Accepting new patients
Reliable Documents Solutions, LLC Current Accepting new patients
Womencare, Inc Current Accepting new patients
Womencare, Inc CurrentSince Jun 1, 2021 Accepting new patients
Womencare Inc CurrentSince Jun 1, 2021 Accepting new patients
Blue Ridge Nursing, LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Autumn Leasing Co., LLC Past Accepting new patients

Locations

2525 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 367-9100

105 Time Sq
Salisbury, MD 21801
Phone (410) 749-2474

183 Holbrook Rd
Buckhannon, WV 26201
Phone (304) 472-3280

12 Kanawha Ter
Saint Albans, WV 25177
Phone (304) 201-1130

Interoperability endpoints

  • Direct secure messaging: nilay.thaker.2@27404.direct.athenahealth.com

Organizations & group practices 9

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.

Hospital & facility affiliations 10

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": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1124275334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6030 DAYBREAK CIRCLE",
            "address_2": "SUITE A150 PMB 263",
            "city": "CLARKSVILLE",
            "state": "MD",
            "postal_code": "210291638",
            "telephone_number": "630-730-0302",
            "fax_number": "304-263-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 WILLIAMSPORT PIKE # 151",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254045707",
            "telephone_number": "630-730-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKER",
        "first_name": "NILAY",
        "middle_name": "BHASKER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-20",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "PA",
            "license": "OS022728",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "WV",
            "license": "3634",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.