Upmc Western Maryland Corporation
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Cumberland, MD
NPI 1174667802 · NPPES record last updated Jan 25, 2022
Key facts
- NPI
- 1174667802
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- License
- CERTIFICATION #44 (MD)
- Legal business name
- UPMC WESTERN MARYLAND CORPORATION
- Practice address
- 12502 Willowbrook Rd
Suite 250
Cumberland, MD 21502-6491 - Phone
- (240) 964-8342
- Fax
- (240) 964-8337
- NPI assigned
- Feb 16, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- UPMC WESTERN MARYLAND CORPORATION
Authorized official
- Name
- Amber Renee Ruble
- Title
- Sr. VP Cfo
- Phone
- (240) 964-8032
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 8
Affiliated clinicians 3
-
Neeharik Mareedu, MD
-
Robert Avrum Welik, MD PA
-
Hassaan Rasheed, MD
Medicare Care Compare: Dialysis facility
- Listed as
- Western Maryland Regional Dialysis Center
- Overall star rating
- ★☆☆☆☆ 1.0 of 5
- Ownership
- Non-profit
- Certified
- Aug 24, 2009
- Medicare certification status
- Active
- Dialysis stations
- 35
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091125000486 | MD | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 7113900655 | Practice locations: Cumberland, MD |
National Provider Directory
- Tax ID family
- Memorial Hospital
- Part of
- Steon Medical Practice
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | CERTIFICATION #44 | MD | Yes |
Addresses
Primary practice location
12502 Willowbrook Rd
Suite 250
Cumberland, MD 21502-6491
Mailing address
12502 Willowbrook Rd
Suite 250
Cumberland, MD 21502-6491
Phone (240) 964-8342
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 59010001 | Other | MD | CAREFIRST BC BS |
| MB4 | Other | DC | BLUE CHOICE |
| 759251500 | Medicaid | MD |
Other names
- UPMC Western Maryland
Other providers in Cumberland, MD
- Brianne Uphold
- Upmc Western Maryland
- Upmc Western Maryland Corporation
- Upmc Western Maryland Corporation
- Upmc Western Maryland Corporation
- Upmc Western Maryland Corporation
- Upmc Western Maryland Corporation
- Upmc Western Maryland Corporation
- Upmc Western Maryland Corporation
- Upmc Western Maryland Corporation
All providers in Cumberland, MD · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.