Individual provider Active NPI

Ross J Vanantwerp, D.O., M.P.H.

  • Internal Medicine Physician
  • Annapolis, MD
National Provider Identifier
1790924512
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
H0033830 Issued in MD
Practice address
1 Park Place Ste 325
Annapolis, MD 21401-3475
Phone
(410) 995-8550
Fax
(410) 514-3582
NPI assigned
Feb 18, 2009
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X H0033830 MD Primary

Addresses

Primary practice location

1 Park Place Ste 325
Annapolis, MD 21401-3475

Mailing address

484 Ritchie Hwy Ste a
Severna Park, MD 21146-2961
Phone (410) 544-4600

Other practice location 1

484 Ritchie Hwy Ste A
Severna Park, MD 21146-2961
Phone (410) 544-4600

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090415000557 MD Practitioner - Internal MedicinePractitioner - Preventive Medicine 1557418241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Preventive Medicine
Education
Michigan State University College of Osteopathic Medicine, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

484 Ritchie Hwy
Suite a
Severna Park, MD 21146-2961
Phone (410) 544-4600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions12
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H0033830MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ross Van Antwerp DO MPH PA Laser Center of Maryland CurrentSince Sep 1, 1989 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

484 Ritchie Hwy
Severna Park, MD 21146
Phone (410) 544-4600

484 Ritchie Hwy
Ste A
Severna Park, MD 21146
Phone (410) 544-4600

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1790924512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 RITCHIE HWY STE A",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462961",
            "telephone_number": "410-544-4600",
            "fax_number": "410-544-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK PLACE STE 325",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013475",
            "telephone_number": "410-995-8550",
            "fax_number": "410-514-3582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "484 Ritchie Hwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Severna Park",
            "state": "MD",
            "postal_code": "211462961",
            "country_code": "US",
            "telephone_number": "410-544-4600",
            "fax_number": "410-544-0997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANANTWERP",
        "first_name": "ROSS",
        "middle_name": "J",
        "credential": "D.O., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-18",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "H0033830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.