NPIMap

Organization Active NPI

Upmc Western Maryland Corporation

Doing business as UPMC Western Maryland

  • Internal Medicine Physician
  • Cumberland, MD
National Provider Identifier
1184769952
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
UPMC WESTERN MARYLAND CORPORATION
Doing business as
UPMC Western Maryland
WMHS Specialty Services
Practice address
12500 Willowbrook Rd
Cumberland, MD 21502-6393
Phone
(240) 964-8342
Fax
(240) 964-8337
NPI assigned
Feb 20, 2007
Last updated
Aug 15, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
UPMC WESTERN MARYLAND CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Amber Ruble
Title
Cfo
Phone
(240) 964-8032

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Registered Dietetic Technician 136A00000X NU
Internal Medicine Physician 207R00000X NU Primary
Cardiovascular Disease Physician 207RC0000X NU
Critical Care Medicine (Internal Medicine) Physician 207RC0200X NU
Gastroenterology Physician 207RG0100X NU
Hematology & Oncology Physician 207RH0003X NU
Infectious Disease Physician 207RI0200X NU
Pulmonary Disease Physician 207RP1001X NU
Neurological Surgery Physician 207T00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Otolaryngology Physician 207Y00000X MD
Surgery Physician 208600000X NU
Trauma Surgery Physician 2086S0127X NU

Addresses

Primary practice location

12500 Willowbrook Rd
Cumberland, MD 21502-6393

Mailing address

PO Box 1671
Cumberland, MD 21501-1671
Phone (240) 964-8342

Other practice location 1

625 Kent Ave
Cumberland, MD 21502-3794
Phone (301) 777-1930

Other practice location 2

40 Main St
Lonaconing, MD 21539-1145
Phone (240) 964-7000

Other practice location 3

12502 Willowbrook Rd
Cumberland, MD 21502-6491
Phone (240) 964-7000

Other identifiers 6

IdentifierTypeStateIssuer
CA1423OtherMDTRAVELERS MEDICARE
K307OtherDCGHMSI BLUE CHOICE
567BOtherMDCARE FIRST MARYLAND
774141301 04MedicaidMD
567BWMOtherMDCAREFIRST
0008670001MedicaidWV

Other names 2

  • UPMC Western Maryland Doing business as
  • WMHS Specialty Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040608000157 MD Part B Supplier - Clinic/Group Practice 7113900655 Receives reassigned benefits from 251 practitioners
8 other NPIs on this enrollment
Practice locations: Lavale, MD; Oakland, MD; MC Henry, MD; Lonaconing, MD; Frostburg, MD; Cumberland, MD

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Upmc Western Maryland Health Services LLC14 organizations share this tax ID, including this one
Part of
Psychaitric Physician S

Other organizations with this tax ID 13

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

View all 13

Locations

12502 Willowbrook Rd
Ste 280
Cumberland, MD 21502
Phone (240) 964-8690

12502 Willowbrook Rd
Ste 580
Cumberland, MD 21502
Phone (301) 723-4218

Practitioners & affiliated clinicians

Practitioners 283

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 283

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1184769952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1671",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215011671",
            "telephone_number": "240-964-8342",
            "fax_number": "240-964-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 WILLOWBROOK RD",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215026393",
            "telephone_number": "240-964-8342",
            "fax_number": "240-964-8337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Kent Ave",
            "address_purpose": "LOCATION",
            "city": "Cumberland",
            "state": "MD",
            "postal_code": "215023794",
            "country_code": "US",
            "telephone_number": "301-777-1930",
            "fax_number": "301-777-8470",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40 Main St",
            "address_purpose": "LOCATION",
            "city": "Lonaconing",
            "state": "MD",
            "postal_code": "215391145",
            "country_code": "US",
            "telephone_number": "240-964-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12502 Willowbrook Rd",
            "address_purpose": "LOCATION",
            "city": "Cumberland",
            "state": "MD",
            "postal_code": "215026491",
            "country_code": "US",
            "telephone_number": "240-964-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UPMC WESTERN MARYLAND CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UPMC WESTERN MARYLAND CORPORATION",
        "enumeration_date": "2007-02-20",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "RUBLE",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "240-964-8032"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "CA1423",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHMSI BLUE CHOICE",
            "identifier": "K307",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST MARYLAND",
            "identifier": "567B",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "774141301  04",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "567BWM",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008670001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UPMC Western Maryland",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WMHS Specialty Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WMHS Specialty Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cumberland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.