Individual provider Active NPI

Theresa Marie Gillis, PA-C

  • Physician Assistant
  • Frederick, MD
National Provider Identifier
1306024476
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0003401 Issued in MD
Practice address
68 Thomas Johnson Dr
Suite C
Frederick, MD 21702-4300
Phone
(301) 694-5292
Fax
(301) 694-2319
NPI assigned
Jan 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0003401 MD Primary

Addresses

Primary practice location

68 Thomas Johnson Dr
Suite C
Frederick, MD 21702-4300

Mailing address

68 Thomas Johnson Dr
Suite C
Frederick, MD 21702-4300
Phone (301) 694-5292

Other practice location 1

504 E Ridgeville Blvd
Mount Airy, MD 21771-5942
Phone (240) 215-6310

Other practice location 2

7211 Bank Ct
Frederick, MD 21703-8483
Phone (240) 215-6310

Other practice location 3

3430 Worthington Blvd
Frederick, MD 21704-7017
Phone (240) 215-6310

Other practice location 4

194 Thomas Johnson Dr
Frederick, MD 21702-4679
Phone (240) 215-6310

Other practice location 5

15 E Frederick St
Walkersville, MD 21793-8234
Phone (240) 215-6310

Other practice location 6

230 W Patrick St
Frederick, MD 21701-6945
Phone (240) 215-6310

Other practice location 7

3000D Ventrie Ct
Myersville, MD 21773-7817
Phone (240) 215-6310

Other practice location 8

501 W 7th St
Frederick, MD 21701-4586
Phone (240) 215-6310

Other practice location 9

1562 Opossumtown Pike
Frederick, MD 21702-4920
Phone (240) 215-6310

Other practice location 10

400 W 7th St
Frederick, MD 21701-4506
Phone (240) 215-6310

Other practice location 11

1194 Dutchmans Creek Dr
Brunswick, MD 21716-9786
Phone (240) 215-6310

Other practice location 12

1 Frederick Health Way
Frederick, MD 21701-9435
Phone (240) 215-6310

Other practice location 13

75 Thomas Johnson Dr
Frederick, MD 21702-4895
Phone (240) 215-6310

Other practice location 14

16403 Old Emmitsburg Rd
Emmitsburg, MD 21727-8929
Phone (240) 215-6310

Other practice location 15

141 Thomas Johnson Dr
Frederick, MD 21702-4502
Phone (301) 846-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080328000344 MD Practitioner - Physician Assistant 3173609286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Frederick Health Way
Frederick, MD 21701-9435
Phone (240) 215-6310

1194 Dutchmans Creek Dr
Brunswick, MD 21716-9786
Phone (240) 215-6310

16403 Old Emmitsburg Rd
Emmitsburg, MD 21727-8929
Phone (240) 215-6310

194 Thomas Johnson Dr
Frederick, MD 21702-4679
Phone (240) 215-6310

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 215-6310

501 W 7TH St
Suite 104
Frederick, MD 21701-5096
Phone (240) 215-6310

504 E Ridgeville Blvd
Mount Airy, MD 21771-5942
Phone (240) 215-6310

7211 Bank CT
Frederick, MD 21703-8482
Phone (240) 215-6310

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.07 of 100Reported as group
Quality
75.5
Promoting interoperability
100
Improvement activities
40
Cost
68.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0003401MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Medical Group LLC CurrentSince Jul 10, 2023 Accepting new patients
Frederick Health Medical Group LLC CurrentSince Jul 10, 2023 Accepting new patients
Frederick Health Medical Group LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1194 Dutchmans Creek Dr
Brunswick, MD 21716
Phone (240) 566-3100

16403 Old Emmitsburg Rd
Emmitsburg, MD 21727
Phone (240) 566-3100

75 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 631-3674

1 Frederick Health Way
Frederick, MD 21701
Phone (240) 439-8812

141 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 620-7478

501 W 7th St
Frederick, MD 21701
Phone (301) 360-2574

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

230 W Patrick St
Frederick, MD 21701
Phone (240) 215-6370

1562 Opossumtown Pike
Frederick, MD 21702
Phone (240) 566-4500

194 Thomas Johnson Dr
Frederick, MD 21702
Phone (240) 215-6370

1562 Opossumtown Pike
Fl 3
Frederick, MD 21702
Phone (301) 663-4774

504 E Ridgeville Blvd
Mount Airy, MD 21771
Phone (301) 703-5452

3000D Ventrie Ct
Myersville, MD 21773
Phone (301) 663-3137

3430 Worthington Blvd
Urbana, MD 21704
Phone (240) 874-2530

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1306024476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 THOMAS JOHNSON DR",
            "address_2": "SUITE C",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024300",
            "telephone_number": "301-694-5292",
            "fax_number": "301-694-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 THOMAS JOHNSON DR",
            "address_2": "SUITE C",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024300",
            "telephone_number": "301-694-5292",
            "fax_number": "301-694-2319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "504 E Ridgeville Blvd",
            "address_purpose": "LOCATION",
            "city": "Mount Airy",
            "state": "MD",
            "postal_code": "217715942",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7211 Bank Ct",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217038483",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3430 Worthington Blvd",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217047017",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "194 Thomas Johnson Dr",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024679",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 E Frederick St",
            "address_purpose": "LOCATION",
            "city": "Walkersville",
            "state": "MD",
            "postal_code": "217938234",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 W Patrick St",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217016945",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3000D Ventrie Ct",
            "address_purpose": "LOCATION",
            "city": "Myersville",
            "state": "MD",
            "postal_code": "217737817",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 W 7th St",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217014586",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1562 Opossumtown Pike",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024920",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W 7th St",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217014506",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1194 Dutchmans Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "MD",
            "postal_code": "217169786",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Frederick Health Way",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217019435",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Thomas Johnson Dr",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024895",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16403 Old Emmitsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Emmitsburg",
            "state": "MD",
            "postal_code": "217278929",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "141 Thomas Johnson Dr",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024502",
            "country_code": "US",
            "telephone_number": "301-846-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0003401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.