NPIMap

Organization Active NPI

Union Hospital of Cecil County, Inc.

Doing business as Union Primary Care of North East

  • Family Medicine Physician
  • North East, MD
National Provider Identifier
1174374102
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNION HOSPITAL OF CECIL COUNTY, INC.
Doing business as
Union Primary Care of North East
Practice address
103 North East PLZ
North East, MD 21901-3633
Phone
(410) 287-5570
NPI assigned
Mar 28, 2024
Last updated
Mar 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Authorized official

Name
Judy Riesen
Title
Corporate Director of Revenue Cycle
Phone
(302) 623-7168

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

103 North East PLZ
North East, MD 21901-3633

Mailing address

207 North St
Elkton, MD 21921-5512
Phone (410) 398-3868

Other names 1

  • Union Primary Care of North East Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121001109 MD Part B Supplier - Clinic/Group Practice 6901719822 Receives reassigned benefits from 546 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rising Sun, MD; Perryville, MD; North East, MD; Elkton, MD

Other NPIs on the same Medicare enrollment 22

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Union Hosp of Cecil Cnty38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

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

View all 37

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1174374102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 NORTH ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215512",
            "telephone_number": "410-398-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 NORTH EAST PLZ",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219013633",
            "telephone_number": "410-287-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION HOSPITAL OF CECIL COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "RIESEN",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "CORPORATE DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "302-623-7168"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Union Primary Care of North East",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North East, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.