Individual provider Active NPI

Ian Tornberg, M.D.

  • Emergency Medicine Physician
  • Rockville, MD
National Provider Identifier
1679009989
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D00948143 Issued in MD
Practice address
9901 Medical Center Dr
Rockville, MD 20850-3357
Phone
(240) 826-6000
NPI assigned
May 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 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 125-069950 IL
Emergency Medicine Physician 207P00000X D00948143 MD Primary

Addresses

Primary practice location

9901 Medical Center Dr
Rockville, MD 20850-3357

Mailing address

9901 Medical Center Dr
Rockville, MD 20850-3357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, 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
I20221104000237 DC Practitioner - Emergency Medicine 3678544970 Reassigns benefits to 1 organization
I20250121002140 MD Practitioner - Emergency Medicine 3678544970 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D00948143MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mep Health, LLC Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients

Locations

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

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1679009989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 MEDICAL CENTER DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 MEDICAL CENTER DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503357",
            "telephone_number": "240-826-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORNBERG",
        "first_name": "IAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-05",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125-069950",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D00948143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.