Individual provider Active NPI

Zachary Durham, DO

  • Emergency Medicine Physician
  • Hagerstown, MD
National Provider Identifier
1558883124
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
H0096516 Issued in MD
Practice address
11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone
(301) 790-8000
NPI assigned
Jul 14, 2017
Last updated
Jun 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5151013959 MI
Emergency Medicine Physician 207P00000X H0096516 MD Primary

Addresses

Primary practice location

11116 Medical Campus Rd
Hagerstown, MD 21742-6710

Mailing address

11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone (417) 597-0368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, MD2 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

Enrollment IDStateProvider typePAC IDDetails
I20210823001439 MI Practitioner - Emergency Medicine 5991039844 Reassigns benefits to 1 organization
I20230626000843 MD Practitioner - Emergency Medicine 5991039844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.24 of 100Reported as group
Quality
75.4
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H0096516MDMDEmergency Medicine Physician
5151013959MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mep Health, LLC Emergency Medicine CurrentSince Jun 8, 2023 Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince Aug 10, 2021 Accepting new patients

Locations

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

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

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

5450 Fort St
Woodhaven, MI 48183
Phone (734) 671-3297

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1558883124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710",
            "telephone_number": "417-597-0368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710",
            "telephone_number": "301-790-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-14",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5151013959",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "H0096516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.