Individual provider Active NPI

Jessica Lyn Tamayo, NP

  • Acute Care Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1588511497
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R223193 Issued in MD
Practice address
11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone
(301) 790-8000
NPI assigned
Mar 11, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R223193 MD Primary

Addresses

Primary practice location

11116 Medical Campus Rd
Hagerstown, MD 21742-6710

Mailing address

11110 Medical Campus Rd Ste 143
Hagerstown, MD 21742-6755
Phone (301) 790-8860

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260515001891 MD Practitioner - Nurse Practitioner 3678042975 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Practices of Antietam, LLCGroup PAC ID 2567353865, 229 clinicians
Meritus Medical Center IncGroup PAC ID 7113811795, 730 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Suite 143
Hagerstown, MD 21742-6755
Phone (301) 704-4350

11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone (301) 790-8000

Hospital & facility affiliations

  • Meritus Medical Center Hospital, Hagerstown, MD, CCN 210001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R223193MDMDAcute Care Nurse Practitioner

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 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": "1773187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1588511497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 143",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426755",
            "telephone_number": "301-790-8860"
        },
        {
            "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": "TAMAYO",
        "first_name": "JESSICA",
        "middle_name": "LYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-11",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R223193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.