Individual provider Active NPI

Brian John McKinnon, MD

  • Otolaryngology Physician
  • Hagerstown, MD
National Provider Identifier
1316945819
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
D0042364 Issued in MD
Practice address
11110 Medical Campus Rd Ste 250
Hagerstown, MD 21742-6756
Phone
(301) 665-4960
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X D0042364 MD Primary
Otolaryngology Physician 207Y00000X S2843 TX

Addresses

Primary practice location

11110 Medical Campus Rd Ste 250
Hagerstown, MD 21742-6756

Mailing address

11110 Medical Campus Rd Ste 250
Hagerstown, MD 21742-6756
Phone (301) 665-4960

Other practice location 1

1600 W League City Pkwy, Ste D
League City, TX 77573-6442
Phone (281) 338-0829

Other identifiers 1

IdentifierTypeStateIssuer
1032208420002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190729001057 TX Practitioner - Otolaryngology 3870598139 Reassigns benefits to 1 organization
I20250820004209 MD Practitioner - Otolaryngology 3870598139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Boston University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians
Medical Practices of Antietam, LLCGroup PAC ID 2567353865, 229 clinicians
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

17301 Valley Mall Rd
Suite 125
Hagerstown, MD 21740-6966
Phone (301) 790-9237

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-2222

Hospital & facility affiliations

  • University of Texas Medical Branch Galveston Hospital, Galveston, TX, CCN 450018
  • Meritus Medical Center Hospital, Hagerstown, MD, CCN 210001

Merit-based Incentive Payment System (MIPS)

Final score
78.88 of 100Reported as group
Quality
73.38
Improvement activities
40
Cost
78.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Practices of Antietam, LLC CurrentSince Aug 7, 2025 Accepting new patients
Medical Practices of Antietam LLC CurrentSince Aug 7, 2025 Accepting new patients
Utmb Faculty Group Practice Otolaryngology CurrentSince Jul 1, 2019 Accepting new patients
Medical Practices of Antietam LLC CurrentSince Aug 7, 2025 Accepting new patients
University of Texas Medical Branch at Galveston PastSince Feb 1, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Ozarks Medical Center Otolaryngology Past Accepting new patients

Locations

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

11110 Medical Campus Rd
Ste 250
Hagerstown, MD 21742
Phone (301) 665-4960

17301 Valley Mall Rd
#125
Hagerstown, MD 21740
Phone (301) 790-9237

3 Byrkit Dr
Williamsport, MD 21795
Phone (301) 582-1150

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001

1600 W League City Pkwy
Ste D
League City, TX 77573
Phone (281) 338-0829

Organizations & group practices 7

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 2

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1316945819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 250",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426756",
            "telephone_number": "301-665-4960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 250",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426756",
            "telephone_number": "301-665-4960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 W League City Pkwy, Ste D",
            "address_purpose": "LOCATION",
            "city": "League City",
            "state": "TX",
            "postal_code": "775736442",
            "country_code": "US",
            "telephone_number": "281-338-0829",
            "fax_number": "281-557-7284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "BRIAN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D0042364",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "S2843",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1032208420002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.