NPIMap

Organization Active NPI

Carroll Regional Cancer Center Physicians, LLC

  • Hematology & Oncology Physician
  • Westminster, MD
National Provider Identifier
1609167998
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
CARROLL REGIONAL CANCER CENTER PHYSICIANS, LLC
Practice address
291 Stoner Ave
Westminster, MD 21157-5647
Phone
(410) 871-6400
Fax
(410) 871-6248
NPI assigned
Apr 21, 2011
Last updated
Nov 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Authorized official

Name
Michael Myers
Title
Vice President
Phone
(410) 871-6114

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X NU Primary
Radiation Oncology Physician 2085R0001X NU

Addresses

Primary practice location

291 Stoner Ave
Westminster, MD 21157-5647

Mailing address

291 Stoner Ave
Westminster, MD 21157-5647
Phone (410) 871-6400

Other practice location 1

200 Memorial Ave
Westminster, MD 21157-5726
Phone (410) 848-3000

Other identifiers 1

IdentifierTypeStateIssuer
336632400MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111010000073 MD Part B Supplier - Clinic/Group Practice 5092987354 Receives reassigned benefits from 16 practitioners
Practice locations: Westminster, MD

National Provider Directory

National Provider Directory
Tax ID family
Carroll Regional Cancer Center Physicians LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

555 S Center St
Westminster, MD 21157
Phone (410) 876-5747

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1609167998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 STONER AVE",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575647",
            "telephone_number": "410-871-6400",
            "fax_number": "410-871-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 STONER AVE",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575647",
            "telephone_number": "410-871-6400",
            "fax_number": "410-871-6248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Memorial Ave",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "MD",
            "postal_code": "211575726",
            "country_code": "US",
            "telephone_number": "410-848-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CARROLL REGIONAL CANCER CENTER PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-21",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "410-871-6114"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336632400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.