Jacques R Conaway, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

D0055034 Issued in MD

Practice address

11107 Cathage Rd Unit 201
Berlin, MD 21811-2156

Phone

(410) 912-6825

Fax

(410) 912-6827

NPI assigned

Oct 5, 2006

Last updated

Sep 29, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MD, DE2 enrollments

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 2

Specialty

Pulmonary DiseaseAlso: Sleep Medicine

Education

University of Maryland School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tidalhealth Physician Network, Inc.Group PAC ID 7315901253, 115 clinicians

Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atlantic General Hospital Hospital, Berlin, MD, CCN 210061
• Tidalhealth Nanticoke, Inc. Hospital, Seaford, DE, CCN 080006
• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019
• Beebe Medical Center Hospital, Lewes, DE, CCN 080007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jconaway90028@direct.umm.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tidalhealth Specialty Care, LLC

  • Medical Specialty Clinic/Center
  • Salisbury, MD
  • NPI 1619504735
  Medicare reassignment Care Compare group NPD
• Tidalhealth Physician Network, Inc.

  • Family Medicine Physician
  • Seaford, DE
  • NPI 1467534636

  Pulmonary Disease

  Medicare reassignment Care Compare group NPD
• Tidalhealth Peninsula Regional, Inc.

  • Family Medicine Physician
  • Salisbury, MD
  • NPI 1184832040

  Pulmonary Disease

  Medicare reassignment NPD
• Sleep Disorders CTRS of the Mid Atlantic LLC

  • Specialist
  • Vienna, VA
  • NPI 1689767683

  MD

  Medicare reassignment NPD
• Delmarva Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Berlin, MD
  • NPI 1922566066
  NPD
• Tidalhealth Peninsula Regional, Inc.

  dba TidalHealth Specialty Pharmacy

  • Community/Retail Pharmacy
  • Salisbury, MD
  • NPI 1871031559
  NPD
• Sleep Disorders CTRS of the Mid Atlantic LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Annapolis, MD
  • NPI 1538339221
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tidalhealth Atlantic, Inc

  dba Atlantic General Hospital Corp

  • General Acute Care Hospital
  • Berlin, MD
  • NPI 1053309120
  Care Compare affiliation
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation
• Beebe Medical Center, Inc.

  • General Acute Care Hospital
  • Lewes, DE
  • NPI 1821196486
  Care Compare affiliation
• Tidalhealth Nanticoke, Inc

  • General Acute Care Hospital
  • Seaford, DE
  • NPI 1245214477
  Care Compare affiliation

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1437245362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015493",
            "telephone_number": "410-546-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11107 CATHAGE RD UNIT 201",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218112156",
            "telephone_number": "410-912-6825",
            "fax_number": "410-912-6827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Rawlins Dr",
            "address_purpose": "LOCATION",
            "city": "Seaford",
            "state": "DE",
            "postal_code": "199735881",
            "country_code": "US",
            "telephone_number": "302-990-3300",
            "fax_number": "302-990-3229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONAWAY",
        "first_name": "JACQUES",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MD",
            "license": "D0055034",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MD",
            "license": "D0055034",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MD",
            "license": "D0055034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE/FEP",
            "identifier": "0017  E554",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE MCO",
            "identifier": "4800365",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "290012458",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "76926302  420A",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1937706",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "296540",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pulmonary Disease Physician in Berlin, MD
• Providers in Berlin, MD by specialty
• Pulmonary Disease Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.
• Medicare Care Compare (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.