Pleasant Valley Primary Care

Key facts

NPI: 1346962149
Entity type: Organization (NPI type 2)
Primary specialty: Family Medicine Physician 207Q00000X
Legal business name: PLEASANT VALLEY PRIMARY CARE
Practice address: 20311 Lappans Rd Ste 100
Boonsboro, MD 21713-2086
Phone: (301) 573-9453
NPI assigned: Sep 19, 2022
Organization subpart: No

Authorized official

Name: Jessica Roelkey, PHYSICIAN ASSISTANT NPI 1619390424
Title: Owner
Phone: (301) 573-9453

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Jessica Roelkey, PA-C Physician Assistant · Boonsboro, MD · NPI 1619390424

Medicare reassignment Care Compare group Authorized official MD
David Henry Roelkey V, M.D. Family Medicine Physician · Boonsboro, MD · NPI 1497927743

Medicare reassignment Care Compare group NPD FAMILY MEDICINE · MD

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
21D2269720	Pleasant Valley Primary Care, LLC 20311 Lappans Rd #100, Boonsboro, MD 21713	Certificate of waiver	Sep 29, 2026

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MD

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20230307002830	MD	Part B Supplier - Clinic/Group Practice	4688047954	Receives reassigned benefits from 2 practitioners Practice locations: Boonsboro, MD

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician Group: 193400000X SINGLE SPECIALTY GROUP	207Q00000X			Yes

Addresses

Primary practice location

20311 Lappans Rd Ste 100
Boonsboro, MD 21713-2086

Mailing address

20311 Lappans Rd Ste 100
Boonsboro, MD 21713-2086
Phone (301) 799-1098

Other providers in Boonsboro, MD

All providers in Boonsboro, MD · Family Medicine Physician in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.