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Frederick Primary Care Associates, P.a.

Organization Active NPI Family Medicine Physician · Jefferson, MD

NPI 1124845797 · NPPES record last updated Jun 23, 2026

Key facts

NPI
1124845797
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
FREDERICK PRIMARY CARE ASSOCIATES, P.A.
Practice address
4014 Mountville Rd
Jefferson, MD 21755-7713
Phone
(301) 834-7188
NPI assigned
Sep 24, 2024
Organization subpart
Yes
Parent organization (as reported)
FREDERICK PRIMARY CARE ASSOCIATES, P.A.

Authorized official

Name
Mr. Scott R Lilly
Title
Ceo
Phone
(301) 663-6162

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 10

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0220867Frederick Primary Care Associates
4014 Mountville Rd, Jefferson, MD 21755		Provider-performed microscopyJan 21, 2028

National Provider Directory

Tax ID family
Frederick Primary Care (11 organizations share this tax ID)
Part of
Frederick Primary Care

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes
Endocrinology, Diabetes & Metabolism Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RE0101X

Addresses

Primary practice location

4014 Mountville Rd
Jefferson, MD 21755-7713

Mailing address

610 Solarex CT
Frederick, MD 21703-8624

Other providers in Jefferson, MD

All providers in Jefferson, MD · Family Medicine Physician in Maryland

Sources for this page

Verify at the official NPI Registry.