NPIMap

Individual provider Active NPI

Tania Ruth Crussiah, M.D.

  • Family Medicine Physician
  • Williamsport, MD
National Provider Identifier
1497962450
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D66288 Issued in MD
Practice address
3 Byrkit Dr
Suite 235
Williamsport, MD 21795-1158
Phone
(301) 582-1150
Fax
(301) 582-0905
NPI assigned
May 17, 2007
Last updated
Dec 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME 95139 FL
Family Medicine Physician 207Q00000X D66288 MD Primary

Addresses

Primary practice location

3 Byrkit Dr
Suite 235
Williamsport, MD 21795-1158

Mailing address

3 Byrkit Dr
Suite 235
Williamsport, MD 21795-1158
Phone (301) 582-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080226000198 MD Practitioner - Family Practice 7719061001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

3 Byrkit Dr
Williamsport, MD 21795-1158
Phone (301) 582-1150

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 95139FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meritus Urgent Care, LLC CurrentSince Sep 1, 2014 Accepting new patients
Medical Practices of Antietam, LLC Family Medicine CurrentSince Jan 1, 2008 Accepting new patients
Medical Practices of Antietam LLC CurrentSince Jan 1, 2008 Accepting new patients
Meritus Urgent Care LLC CurrentSince Sep 1, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Meritus Medical Laboratory LLC Past Accepting new patients

Locations

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

13620 Crayton Blvd
Hagerstown, MD 21742
Phone (240) 313-3100

3 Byrkit Dr
Williamsport, MD 21795
Phone (301) 582-1150

3 Byrkit Dr
Ste 235
Williamsport, MD 21795
Phone (301) 582-1150

Organizations & group practices 6

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 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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1497962450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BYRKIT DR",
            "address_2": "SUITE 235",
            "city": "WILLIAMSPORT",
            "state": "MD",
            "postal_code": "217951158",
            "telephone_number": "301-582-1150",
            "fax_number": "301-582-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BYRKIT DR",
            "address_2": "SUITE 235",
            "city": "WILLIAMSPORT",
            "state": "MD",
            "postal_code": "217951158",
            "telephone_number": "301-582-1150",
            "fax_number": "301-582-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUSSIAH",
        "first_name": "TANIA",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 95139",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D66288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, MD

Sources for this page

Verify at the official NPI Registry.