Individual provider Active NPI

Bert Edward Williams, MD

  • Urology Physician
  • Frederick, MD
National Provider Identifier
1497813208
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
D0054397 Issued in MD
Practice address
97 Thomas Johnson Drive
Suite 102
Frederick, MD 21702-4379
Phone
(301) 694-0414
Fax
(301) 694-0415
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X D0054397 MD Primary

Addresses

Primary practice location

97 Thomas Johnson Drive
Suite 102
Frederick, MD 21702-4379

Mailing address

97 Thomas Johnson Drive
Suite 102
Frederick, MD 21702-4379
Phone (301) 694-0414

Other identifiers 1

IdentifierTypeStateIssuer
808003800MedicaidMD

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
I20100216000096 MD Practitioner - Urology 8628146800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Howard University College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

97 Thomas Johnson Dr
Suite 102
Frederick, MD 21702-4379
Phone (301) 694-0414

Hospital & facility affiliations

  • Frederick Health Hospital Hospital, Frederick, MD, CCN 210005
  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065
  • Upmc Hanover Hospital, Hanover, PA, CCN 390233

Merit-based Incentive Payment System (MIPS)

Final score
30 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0054397MDMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 2

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 5

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1497813208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 THOMAS JOHNSON DRIVE",
            "address_2": "SUITE 102",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024379",
            "telephone_number": "301-694-0414",
            "fax_number": "301-694-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 THOMAS JOHNSON DRIVE",
            "address_2": "SUITE 102",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024379",
            "telephone_number": "301-694-0414",
            "fax_number": "301-694-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BERT",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MD",
            "license": "D0054397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808003800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.