NPIMap

Organization Active NPI

Meritus Medical Center Inc

Doing business as Meritus Physicians-Center for Advanced Healing & Hyperbaric Medicine

  • Emergency Medicine Physician
  • Hagerstown, MD
National Provider Identifier
1396980405
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
21-012 Issued in MD
Legal business name
MERITUS MEDICAL CENTER INC
Doing business as
Meritus Physicians-Center for Advanced Healing & Hyperbaric Medicine
Practice address
11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone
(240) 313-9580
Fax
(240) 313-9581
NPI assigned
Dec 4, 2008
Last updated
Oct 26, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MERITUS MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Authorized official

Name
Mr. Joshua Repac
Title
Cfo
Phone
(301) 790-9351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21-012 MD Primary

Addresses

Primary practice location

11116 Medical Campus Rd
Hagerstown, MD 21742-6710

Mailing address

11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone (301) 790-8102

Other identifiers 2

IdentifierTypeStateIssuer
K025OtherMDMEDICARE PART B
949701305MedicaidMD

Other names 1

  • Meritus Physicians-Center for Advanced Healing & Hyperbaric Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040212000950 MD Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 320 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fulton, MD; Ellicott City, MD; Hagerstown, MD; Severna Park, MD; Frederick, MD; Edgewater, MD; Cumberland, MD; Crownsville, MD…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Part of
Washngton Co Hos Ass-Su

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1396980405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710",
            "telephone_number": "301-790-8102",
            "fax_number": "301-797-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710",
            "telephone_number": "240-313-9580",
            "fax_number": "240-313-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERITUS MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERITUS MEDICAL CENTER INC",
        "enumeration_date": "2008-12-04",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "REPAC",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-790-9351",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "21-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "K025",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "949701305",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meritus Physicians-Center for Advanced Healing & Hyperbaric Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Meritus Physicians-Center for Advanced Healing & Hyperbaric Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.