Individual provider Active NPI

Pamela C Mumba, PA

  • Physician Assistant
  • Frederick, MD
National Provider Identifier
1770051294
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C08100 Issued in MD
Practice address
194 Thomas Johnson Dr
Frederick, MD 21702-4679
Phone
(240) 215-6310
NPI assigned
Nov 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA7177 MA
Physician Assistant 363A00000X C08100 MD Primary

Addresses

Primary practice location

194 Thomas Johnson Dr
Frederick, MD 21702-4679

Mailing address

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 439-8812

Other practice location 1

759 Chestnut Street
Springfield, MA 01107-1619
Phone (413) 794-6297

Other practice location 2

1562 Opossumtown Pike
Frederick, MD 21702-4920
Phone (240) 215-6310

Other practice location 3

3430 Worthington Blvd
Frederick, MD 21704-7017
Phone (240) 215-6310

Other practice location 4

7211 Bank Ct
Frederick, MD 21703-8483
Phone (240) 215-6310

Other practice location 5

3000D Ventrie Ct
Myersville, MD 21773-7817
Phone (240) 215-6310

Other practice location 6

16403 Old Emmitsburg Rd
Emmitsburg, MD 21727-8929
Phone (240) 215-6310

Other practice location 7

230 W Patrick St
Frederick, MD 21701-6945
Phone (240) 215-6310

Other practice location 8

15 E Frederick St
Walkersville, MD 21793-8234
Phone (240) 215-6310

Other practice location 9

141 Thomas Johnson Dr
Frederick, MD 21702-4502
Phone (301) 846-0100

Other practice location 10

400 W 7th St
Frederick, MD 21701-4506
Phone (240) 215-6310

Other practice location 11

501 W 7th St
Frederick, MD 21701-4586
Phone (240) 215-6310

Other practice location 12

75 Thomas Johnson Dr
Frederick, MD 21702-4895
Phone (240) 215-6310

Other practice location 13

504 E Ridgeville Blvd
Mount Airy, MD 21771-5942
Phone (240) 215-6310

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
I20211019003450 MD Practitioner - Physician Assistant 3274863956 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 215-6310

504 E Ridgeville Blvd
Mount Airy, MD 21771-5942
Phone (240) 215-6310

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Medical Group LLC CurrentSince Jan 2, 2023 Accepting new patients
Meritus Medical Center Inc CurrentSince Jan 1, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Frederick Health Medical Group LLC Past Accepting new patients

Locations

16403 Old Emmitsburg Rd
Emmitsburg, MD 21727
Phone (240) 566-3100

194 Thomas Johnson Dr
Frederick, MD 21702
Phone (240) 215-6370

141 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 620-7478

501 W 7th St
Frederick, MD 21701
Phone (301) 360-2574

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

75 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 631-3674

1562 Opossumtown Pike
Frederick, MD 21702
Phone (240) 566-4500

230 W Patrick St
Frederick, MD 21701
Phone (240) 215-6370

1562 Opossumtown Pike
Fl 3
Frederick, MD 21702
Phone (301) 663-4774

1562 Opossumtown Pike
Ste 302
Frederick, MD 21702

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

504 E Ridgeville Blvd
Mount Airy, MD 21771
Phone (301) 703-5452

3000D Ventrie Ct
Myersville, MD 21773
Phone (301) 663-3137

3430 Worthington Blvd
Urbana, MD 21704
Phone (240) 874-2530

Organizations & group practices 6

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": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1770051294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506",
            "telephone_number": "240-439-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 THOMAS JOHNSON DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024679",
            "telephone_number": "240-215-6310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "759 Chestnut Street",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011071619",
            "country_code": "US",
            "telephone_number": "413-794-6297",
            "fax_number": "413-794-1767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1562 Opossumtown Pike",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024920",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3430 Worthington Blvd",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217047017",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7211 Bank Ct",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217038483",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3000D Ventrie Ct",
            "address_purpose": "LOCATION",
            "city": "Myersville",
            "state": "MD",
            "postal_code": "217737817",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16403 Old Emmitsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Emmitsburg",
            "state": "MD",
            "postal_code": "217278929",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 W Patrick St",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217016945",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 E Frederick St",
            "address_purpose": "LOCATION",
            "city": "Walkersville",
            "state": "MD",
            "postal_code": "217938234",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "141 Thomas Johnson Dr",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024502",
            "country_code": "US",
            "telephone_number": "301-846-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W 7th St",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217014506",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 W 7th St",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217014586",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Thomas Johnson Dr",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024895",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "504 E Ridgeville Blvd",
            "address_purpose": "LOCATION",
            "city": "Mount Airy",
            "state": "MD",
            "postal_code": "217715942",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUMBA",
        "first_name": "PAMELA",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-02",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA7177",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C08100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.