Active NPI
Richard Christian Habersat, M.D.
- Adolescent Medicine (Internal Medicine) Physician
- Parkton, MD
National Provider Identifier
1336133545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adolescent Medicine (Internal Medicine) Physician
- License
- D18822
- Practice address
- 111 Mount Carmel Rd
Suite 500
Parkton, MD 21120-9706 - Phone
- (410) 343-1020
- Fax
- (410) 343-2494
- NPI assigned
- Sep 1, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent Medicine (Internal Medicine) Physician | 207RA0000X | D18822 | MD | Primary |
Addresses
Primary practice location
111 Mount Carmel Rd
Suite 500
Parkton, MD 21120-9706
Mailing address
111 Mt Carmel Road
Parkton, MD 21120
Phone (410) 343-1020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 258171000 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170622001211 | PA | Practitioner - Internal Medicine | 9638293129 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD480381 | PA | MD | Neurology with Special Qualifications in Child Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Windber Hospital, Inc. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- General Acute Care Hospital
- Windber, PA
- NPI 1275620536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275609600000",
"number": "1336133545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 MT CARMEL ROAD",
"city": "PARKTON",
"state": "MD",
"postal_code": "21120",
"telephone_number": "410-343-1020",
"fax_number": "410-343-2494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MOUNT CARMEL RD",
"address_2": "SUITE 500",
"city": "PARKTON",
"state": "MD",
"postal_code": "211209706",
"telephone_number": "410-343-1020",
"fax_number": "410-343-2494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HABERSAT",
"first_name": "RICHARD",
"middle_name": "CHRISTIAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-01",
"last_updated": "2010-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RA0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Adolescent Medicine",
"state": "MD",
"license": "D18822",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "258171000",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Parkton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.