Active NPI
Herman Wallace Brubaker, MD
- Family Medicine Physician
- Chambersburg, PA
National Provider Identifier
1609870054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD028694E
- Practice address
- 12 St Paul Dr Ste 101
Chambersburg, PA 17201-1035 - Phone
- (717) 217-6760
- Fax
- (717) 217-6912
- NPI assigned
- Jun 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD028694E | PA | Primary |
Addresses
Primary practice location
12 St Paul Dr Ste 101
Chambersburg, PA 17201-1035
Mailing address
785 5TH Ave
Suite 3
Chambersburg, PA 17201-4232
Phone (717) 263-9555
Other practice location 1
12 St Paul Dr Ste 203
Chambersburg, PA 17201-1035
Phone (717) 264-6511
Other identifiers 20
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080086589 | Other | PA | RAILROAD MEDICARE |
| 4397945 | Other | PA | AETNA NON-HMO |
| 867633 | Other | PA | MEDICARE GROUP # |
| 25-1716306 | Other | PA | MULTIPLAN/PHCS |
| 426224 | Other | PA | HEALTH AMERICA |
| P006020 | Other | PA | GATEWAY |
| 1806901 | Other | PA | CAPITAL BLUECROSS |
| 25-1716306 | Other | PA | INFORMED |
| 25-1716306 | Other | PA | DEVON |
| 25-1716306 | Other | PA | SOUTH CENTRAL PREFERRED |
| 000908788 | Medicaid | PA | |
| 247728 | Other | PA | MAMSI |
| 122715 | Other | PA | UNISON |
| 666058 | Other | PA | FIRST HEALTH |
| MD028694E | Other | PA | LICENSE |
| 120420409 | Other | PA | DEPT OF LABOR |
| 25-1716306 | Other | PA | INTERGROUP |
| 25-1716306 | Other | PA | GREATWEST |
| 842753 | Other | PA | AETNA HMO |
| BR426736 | Other | PA | HIGHMARK BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1609870054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "785 5TH AVE",
"address_2": "SUITE 3",
"city": "CHAMBERSBURG",
"state": "PA",
"postal_code": "172014232",
"telephone_number": "717-263-9555",
"fax_number": "717-217-4218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 ST PAUL DR STE 101",
"city": "CHAMBERSBURG",
"state": "PA",
"postal_code": "172011035",
"telephone_number": "717-217-6760",
"fax_number": "717-217-6912"
}
],
"practiceLocations": [
{
"address_1": "12 St Paul Dr Ste 203",
"address_purpose": "LOCATION",
"city": "Chambersburg",
"state": "PA",
"postal_code": "172011035",
"country_code": "US",
"telephone_number": "717-264-6511",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRUBAKER",
"first_name": "HERMAN",
"middle_name": "WALLACE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2023-03-07",
"certification_date": "2021-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD028694E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080086589",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA NON-HMO",
"identifier": "4397945",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP #",
"identifier": "867633",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN/PHCS",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH AMERICA",
"identifier": "426224",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "P006020",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUECROSS",
"identifier": "1806901",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INFORMED",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEVON",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTH CENTRAL PREFERRED",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000908788",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "247728",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON",
"identifier": "122715",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "666058",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "MD028694E",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR",
"identifier": "120420409",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERGROUP",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREATWEST",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "842753",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "BR426736",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chambersburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.