Individual provider Active NPI

Adrian E. Park, M.D.

  • Surgery Physician
  • Hagerstown, MD
National Provider Identifier
1376567099
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D60890 Issued in MD
Practice address
11110 Medical Campus Rd Ste 143
Hagerstown, MD 21742-6755
Phone
(301) 714-4350
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X D60890 MD Primary

Addresses

Primary practice location

11110 Medical Campus Rd Ste 143
Hagerstown, MD 21742-6755

Mailing address

11110 Medical Campus Rd Ste 143
Hagerstown, MD 21742-6755

Other practice location 1

2000 Medical Pkwy
Suite 600
Annapolis, MD 21401-3742
Phone (443) 481-6699

Other identifiers 7

IdentifierTypeStateIssuer
240838OtherMDKAISER
Y7920001OtherBCBS MD
2114812OtherMDMDIPA
P01240294OtherRAILROAD MEDICARE
403374400MedicaidMD
0088OtherMDCAREFIRST REGIONAL
82499OtherMDGEISINGER

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040323000186 MD Practitioner - General Surgery 0840181533 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D60890MDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meritus Medical Center Inc CurrentSince Jul 31, 2023 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jan 13, 2012 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jan 13, 2012 Accepting new patients
Meritus Medical Center Inc CurrentSince Jul 31, 2023 Accepting new patients
Meritus Medical Center Inc Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

2000 Medical Pkwy
Ste 600
Annapolis, MD 21401
Phone (443) 481-6699

2000 Medical Pkwy
Ste 510
Annapolis, MD 21401
Phone (443) 481-4600

2000 Medical Pkwy
Cpe St Claire, MD 21401
Phone (443) 481-3400

11110 Medical Campus Rd
Ste 147
Hagerstown, MD 21742
Phone (240) 313-9600

11110 Medical Campus Rd
Ste 143
Hagerstown, MD 21742
Phone (301) 714-4175

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

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

Interoperability endpoints

  • Direct secure messaging: apark22825@direct.aahs.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1376567099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 143",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 143",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426755",
            "telephone_number": "301-714-4350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Medical Pkwy",
            "address_2": "Suite 600",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MD",
            "postal_code": "214013742",
            "country_code": "US",
            "telephone_number": "443-481-6699",
            "fax_number": "443-481-6713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "ADRIAN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D60890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "240838",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "Y7920001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDIPA",
            "identifier": "2114812",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01240294",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403374400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST REGIONAL",
            "identifier": "0088",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "82499",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.