NPIMap

Organization Active NPI

St Marys Hospital of St Marys County Inc

Doing business as MedStar St. Mary's Hospital

  • General Acute Care Hospital
  • Leonardtown, MD
National Provider Identifier
1780650473
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
18-001 Issued in MD
Legal business name
ST MARYS HOSPITAL OF ST MARYS COUNTY INC
Doing business as
MedStar St. Mary's Hospital
Practice address
25500 Point Lookout Rd
Leonardtown, MD 20650
Phone
(301) 475-6003
NPI assigned
Feb 23, 2006
Last updated
Apr 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Authorized official

Name
Mr. Michael Meisel
Title
Chief Financial Officer
Phone
(301) 475-6003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 18-001 MD Primary

Addresses

Primary practice location

25500 Point Lookout Rd
Leonardtown, MD 20650

Mailing address

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6003

Other names 1

  • MedStar St. Mary's Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080114000254 MD Part A Provider - Hospital 4789589912 Practice locations: Leonardtown, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780650473. Details of each certification follow.

Hospital certification: CCN 210028

Legal name
ST MARYS HOSPITAL OF ST MARYS COUNTY INC
Doing business as
MEDSTAR ST. MARY'S HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 7, 1993
Beds
107
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
25500 Point Lookout Rd
Leonardtown, MD 20650-2015
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Medstar Saint Mary's HospitalCCN 210028 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0701795Medstar St Mary's Hospital25500 Point Lookout Road, Leonardtown, MD 20650Provider-performed microscopyOct 26, 2026
21D0705218Medstar St Mary's Hospital25500 Point Lookout Road P O Box 527, Leonardtown, MD 20650AccreditationJan 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
St Mary's Hospital Specialists12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Yahia M Tagouri Individual Corporate DirectorBoard Member Jul 1, 2019
Anne Banfield Individual Corporate DirectorBoard Member Sep 21, 2023
Tara Saggar Individual Corporate DirectorBoard Member Jul 1, 2018
W-2 Managing Employee Jul 1, 2018
John Harvey Individual Corporate DirectorBoard Member Aug 26, 2016
Karen Garner Individual Corporate DirectorBoard Member Jul 1, 2017
Kenneth a Samet Individual Corporate DirectorCeo Sep 30, 2009
Vincent Whittles Individual Corporate DirectorBoard Member Jul 1, 2017
Glen Ives Individual Corporate Director Oct 31, 2021
Nona P Novello Individual Corporate Officer Jan 29, 2022
Corporate Director Jan 29, 2022
W-2 Managing EmployeeAd; Jan 29, 2022
Operational/Managerial ControlPresident Jan 29, 2022
St Marys Hospital of St Marys County Inc Organization, Leonardtown, MD Created for acquisition, Corporation, Non-profit 5% Or Greater Direct Ownership Interest Sep 30, 2009 100%
Operational/Managerial Control Sep 30, 2009
Sonya Pollock Individual Corporate Director Oct 31, 2021
Katherine Koch Individual Corporate DirectorBoard Member Dec 20, 2023
Thomas Clark Individual Corporate Director Sep 12, 2024
Eric Golden Individual Corporate Director Dec 12, 2024
Purvi Jani Individual Corporate Officer Feb 1, 2024
W-2 Managing EmployeeAd;Cfo Feb 1, 2024
Operational/Managerial ControlCfo Feb 1, 2024
Medstar Health, Inc. Organization, Columbia, MD Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Sep 30, 2009 100%

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 13

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 13

Practitioners & affiliated clinicians

Practitioners 38

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 38

Affiliated clinicians 518

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 518

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1780650473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 POINT LOOKOUT RD",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "20650",
            "telephone_number": "301-475-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 POINT LOOKOUT RD",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "20650",
            "telephone_number": "301-475-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARYS HOSPITAL OF ST MARYS COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "MEISEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "301-475-6003",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MD",
            "license": "18-001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd Ste 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MedStar St. Mary's Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leonardtown, MD

Sources for this page

Verify at the official NPI Registry.