Individual provider Active NPI

Ethan A Urbansky, PAC

  • Physician Assistant
  • Germantown, MD
National Provider Identifier
1457786139
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0010009 Issued in MD
Practice address
20410 Century Blvd
Medstar NRH Rehab Network - #215
Germantown, MD 20874-1186
Phone
(301) 540-6130
Fax
(301) 540-5190
NPI assigned
Sep 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0010009 MD Primary
Athletic Trainer 2255A2300X A0000250 MD

Addresses

Primary practice location

20410 Century Blvd
Medstar NRH Rehab Network - #215
Germantown, MD 20874-1186

Mailing address

74 Thomas Johnson Dr
Frederick, MD 21702-4501
Phone (301) 540-6130

Other practice location 1

74 Thomas Johnson Dr
Frederick, MD 21702-4501
Phone (301) 694-9033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250915004286 MD Practitioner - Physician Assistant 9931603867 Reassigns benefits to 2 organizations
I20250924003243 DC Practitioner - Physician Assistant 9931603867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2000 Medical Pkwy
Suite 409
Annapolis, MD 21401-3746

74 Thomas Johnson Dr
Frederick, MD 21702-4501

74 Thomas Johnson Dr
Frederick, MD 21702-5182

PO Box
Suite 778
Easton, MD 21601

Hospital & facility affiliations

  • Frederick Health Hospital Hospital, Frederick, MD, CCN 210005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
A0000250MDMDAthletic Trainer
C0010009MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince Aug 1, 2025 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Aug 1, 2025 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Aug 1, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Sherman Kahan, MD, PA PastSince Jan 19, 2010 Accepting new patients

Locations

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

2000 Medical Pkwy
Ste 409
Annapolis, MD 21401
Phone (443) 481-5136

4175 N Hanson Ct
Ste 201
Bowie, MD 20716
Phone (443) 481-1199

Interoperability endpoints

  • Direct secure messaging: eurbansky185843@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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1457786139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 THOMAS JOHNSON DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024501",
            "telephone_number": "301-540-6130",
            "fax_number": "301-540-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20410 CENTURY BLVD",
            "address_2": "MEDSTAR NRH REHAB NETWORK - #215",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741186",
            "telephone_number": "301-540-6130",
            "fax_number": "301-540-5190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "74 Thomas Johnson Dr",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024501",
            "country_code": "US",
            "telephone_number": "301-694-9033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "URBANSKY",
        "first_name": "ETHAN",
        "middle_name": "A",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-12",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0010009",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0000250",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

Verify at the official NPI Registry.