NPIMap

Organization Active NPI

Meritus Medical Center Inc

Doing business as Meritus Radiology

  • Diagnostic Radiology Physician
  • Hagerstown, MD
National Provider Identifier
1184477911
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MERITUS MEDICAL CENTER INC
Doing business as
Meritus Radiology
Practice address
11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone
(301) 790-8000
NPI assigned
Apr 10, 2024
Last updated
Apr 10, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MERITUS MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Authorized official

Name
Joshua Repac
Title
Cfo
Phone
(301) 790-9351

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X NU
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

11116 Medical Campus Rd
Hagerstown, MD 21742-6710

Mailing address

11116 Medical Campus Rd
Hagerstown, MD 21742-6710

Other names 1

  • Meritus Radiology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, FL, NY, CA, PA, OH, UT, NE, NJ, TX, WI, SC, NC, VA, MN, NV, WA, CO, GA, CT20 enrollments

Enrollment records 20

Enrollment IDStateProvider typePAC IDDetails
O20040212000950 MD Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 320 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fulton, MD; Ellicott City, MD; Hagerstown, MD; Severna Park, MD; Frederick, MD; Edgewater, MD; Cumberland, MD; Crownsville, MD…
O20240716004355 FL Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 5 practitioners
Practice locations: Boca Raton, FL; Belleair, FL; Windermere, FL; Tampa, FL; Davie, FL; Port St Lucie, FL
O20241015002865 NY Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 2 practitioners
Practice locations: Long Island City, NY; Howard Beach, NY; Delmar, NY
O20241016001859 CA Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 3 practitioners
Practice locations: Beverly Hills, CA; Claremont, CA; San Marcos, CA
O20241030001390 PA Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 3 practitioners
Practice locations: Reading, PA; Holland, PA; Gibsonia, PA
O20241108002087 OH Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 2 practitioners
Practice locations: Beavercreek, OH; Marion, OH
O20250211000332 UT Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 2 practitioners
Practice locations: Bountiful, UT; Farmington, UT
O20250212002143 NE Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 1 practitioner
Practice locations: Papillion, NE
O20250213003952 NJ Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 1 practitioner
Practice locations: Glen Ridge, NJ
O20250224000061 TX Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 4 practitioners
Practice locations: The Hills, TX; Plano, TX; Allen, TX; Fort Worth, TX
O20250314000418 WI Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 1 practitioner
Practice locations: Madison, WI
O20250417001818 SC Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Pleasant, SC
O20250509002389 NC Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 2 practitioners
Practice locations: Clayton, NC; Sanford, NC
O20250528002658 VA Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 31 practitioners
Practice locations: Big Stone Gap, VA; Fredericksburg, VA
O20250723003620 MN Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 1 practitioner
Practice locations: Stillwater, MN
O20250728001298 NV Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 2 practitioners
Practice locations: Reno, NV; Las Vegas, NV
O20251112002597 WA Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 1 practitioner
Practice locations: Bellevue, WA
O20251113002303 CO Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 1 practitioner
Practice locations: Littleton, CO
O20260413003180 GA Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 1 practitioner
Practice locations: Marietta, GA
O20260512002680 CT Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 1 practitioner
Practice locations: Avon, CT

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Washngton Co Hos Ass-Su40 organizations share this tax ID, including this one
Part of
Washngton Co Hos Ass-Su

Other organizations with this tax ID 39

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

View all 39

Locations

187 Thomas Johnson Dr
Ste 101
Frederick, MD 21702
Phone (301) 378-9421

11110 Medical Campus Rd
Ste 129
Hagerstown, MD 21742
Phone (301) 665-4650

1198 Kenly Ave
Hagerstown, MD 21740
Phone (240) 313-9600

13424 Pennsylvania Ave
Ste 104
Hagerstown, MD 21742
Phone (240) 313-3100

747 Northern Ave
#102
Hagerstown, MD 21742
Phone (240) 313-9600

10401 Spotsylvania Ave
Ste 207
Fredericksburg, VA 22408

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Meritus Home HealthHagerstown, MD, CCN 217085 Home health agency 5% Or Greater Direct Ownership Interest (100%) May 21, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 448

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.

View all 448

NPI Registry JSON

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

{
    "created_epoch": "1712707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1184477911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710",
            "telephone_number": "301-790-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERITUS MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERITUS MEDICAL CENTER INC",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "REPAC",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-790-9351"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meritus Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.