Active NPI
Adrian E. Park, M.D.
- Surgery Physician
- Hagerstown, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- D60890
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 240838 | Other | MD | KAISER |
| Y7920001 | Other | BCBS MD | |
| 2114812 | Other | MD | MDIPA |
| P01240294 | Other | RAILROAD MEDICARE | |
| 403374400 | Medicaid | MD | |
| 0088 | Other | MD | CAREFIRST REGIONAL |
| 82499 | Other | MD | GEISINGER |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| D60890 | MD | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meritus Medical Center Inc | Current | Accepting new patients | |
| Luminis Health Medical Group, LLC | Current | Accepting new patients | |
| Luminis Health Medical Group, LLC | Current | Accepting new patients | |
| Luminis Health Medical Group, LLC | Current | Accepting new patients | |
| Meritus Medical Center Inc | Current | 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
- 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.
-
- Maternal & Fetal Medicine Physician
- Annapolis, MD
- NPI 1073580205
MD
-
- Gastroenterology Physician
- Annapolis, MD
- NPI 1598598245
-
- Internal Medicine Physician
- Bowie, MD
- NPI 1720835010
-
- Diagnostic Radiology Physician
- Hagerstown, MD
- NPI 1184477911
-
- Cardiac Rehabilitation Clinic/Center
- Hagerstown, MD
- NPI 1245256213
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.