Bryan Jeffrey Peralta

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

R197653 Issued in MD

Practice address

22911 Jefferson Blvd
Smithsburg, MD 21783-1617

Phone

(301) 824-3343

NPI assigned

Sep 11, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians

Medical Practices of Antietam, LLCGroup PAC ID 2567353865, 229 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Medical Practices of Antietam LLC

  • Clinic/Center
  • Hagerstown, MD
  • NPI 1710854963
  Medicare reassignment Care Compare group NPD
• Mdics at Meritus Medical Center, LLC

  • Hospitalist Physician
  • Hagerstown, MD
  • NPI 1306258645
  Medicare reassignment NPD
• Meritus Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Hagerstown, MD
  • NPI 1134383623
  Medicare reassignment NPD
• Medical Practices of Antietam, LLC

  • General Practice Physician
  • Hagerstown, MD
  • NPI 1558430843
  NPD
• Meritus Urgent Care LLC

  • Urgent Care Clinic/Center
  • Hagerstown, MD
  • NPI 1972379568
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Meritus Medical Laboratory LLC

  • Clinical Medical Laboratory
  • Hagerstown, MD
  • NPI 1679518971
  NPD (past)

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1801379490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18415 WISSETT WAY",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217401699",
            "telephone_number": "570-898-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22911 JEFFERSON BLVD",
            "city": "SMITHSBURG",
            "state": "MD",
            "postal_code": "217831617",
            "telephone_number": "301-824-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERALTA",
        "first_name": "BRYAN",
        "middle_name": "JEFFREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R197653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dipti Mohanlal Mistry, MD
• Jennifer Lynn Nunnelee, PA
• Thomas M Nussear, DDS
• Jason T O'Neal, PHARMD
• Matthew E Paper, D.D.S.
• Linda Potts, ND,DCRC,RN,MBA,MBE
• Gary Schwartz
• Smithsburg Emergency Medical Services Inc
• Smithsburg Pharmacy LLC
• Qianyiren Song

• Acute Care Nurse Practitioner in Smithsburg, MD
• Providers in Smithsburg, MD by specialty
• Acute Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.