Individual provider Active NPI

Rhoda Abisola Vandyck, M.D.

  • Obstetrics & Gynecology Physician
  • Hagerstown, MD
National Provider Identifier
1467612606
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
D0076699 Issued in MD
Practice address
11110 Medical Campus Rd
Suite 249
Hagerstown, MD 21742-6700
Phone
(301) 714-4109
NPI assigned
Jun 11, 2008
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X D0076699 MD Primary

Addresses

Primary practice location

11110 Medical Campus Rd
Suite 249
Hagerstown, MD 21742-6700

Mailing address

11110 Medical Campus Rd
Ste 249
Hagerstown, MD 21742-6700
Phone (301) 714-4100

Other identifiers 1

IdentifierTypeStateIssuer
070325700MedicaidMD

Other names 1

  • Rhoda A Raji Former name

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
I20131210000667 MD Practitioner - Obstetrics/GynecologyPractitioner - Critical Care (Intensivists) 0840427225 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Critical Care (Intensivists)
Education
Tufts University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

2000 Medical Pkwy
Annapolis, MD 21401-3742
Phone (443) 481-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0076699MDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shock Trauma Associates, P.a. CurrentSince Dec 11, 2013 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jun 15, 2016 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jun 15, 2016 Accepting new patients
Obhg Maryland PC Obstetrics & Gynecology CurrentSince Aug 1, 2022 Accepting new patients
Obhg Maryland PC Obstetrics & Gynecology CurrentSince Aug 1, 2022 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
St Agnes Healthcare Inc CurrentSince Jul 15, 2024 Accepting new patients
St Agnes Healthcare Inc Obstetrics & Gynecology CurrentSince Jul 15, 2024 Accepting new patients
Luminis Health Anne Arundel Medical Center, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

2000 Medical Pkwy
Ste 309
Annapolis, MD 21401
Phone (410) 224-1133

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

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

500 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (443) 643-1000

219 S Washington St
Easton, MD 21601

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

Interoperability endpoints

  • Direct secure messaging: rraji233482@direct.umm.edu

Organizations & group practices 11

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.

Hospital & facility affiliations 2

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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1467612606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD",
            "address_2": "STE 249",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426700",
            "telephone_number": "301-714-4100",
            "fax_number": "301-714-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD",
            "address_2": "SUITE 249",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426700",
            "telephone_number": "301-714-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYCK",
        "first_name": "RHODA",
        "middle_name": "ABISOLA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D0076699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070325700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RHODA",
            "last_name": "RAJI",
            "middle_name": "A",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.