Individual provider Active NPI

Maria D Merzouk, D.O.

  • Gynecologic Oncology Physician
  • Hagerstown, MD
National Provider Identifier
1811908023
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
H85851 Issued in MD
Practice address
11110 Medical Campus Rd Ste 249
Hagerstown, MD 21742-6756
Phone
(301) 714-4100
Fax
(301) 714-4101
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 2181 WV
Gynecologic Oncology Physician 207VX0201X H85851 MD Primary

Addresses

Primary practice location

11110 Medical Campus Rd Ste 249
Hagerstown, MD 21742-6756

Mailing address

11110 Medical Campus Rd Ste 249
Hagerstown, MD 21742-6756
Phone (301) 714-4100

Other identifiers 1

IdentifierTypeStateIssuer
3810005936MedicaidWV

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
I20180730001488 MD Practitioner - Obstetrics/Gynecology 6901809573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
West Virginia School of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Practices of Antietam, LLCGroup PAC ID 2567353865, 229 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Suite 107
Hagerstown, MD 21742-6734
Phone (301) 714-4100

Hospital & facility affiliations

  • Berkeley Medical Center Hospital, Martinsburg, WV, CCN 510008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H85851MDMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Practices of Antietam, LLC CurrentSince Jul 11, 2018 Accepting new patients
Medical Practices of Antietam LLC CurrentSince Jul 11, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

11110 Medical Campus Rd
Ste 249
Hagerstown, MD 21742
Phone (301) 665-9098

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

11110 Medical Campus Rd
Ste 107
Hagerstown, MD 21742
Phone (301) 714-4100

11110 Medical Campus Rd
Hagerstown, MD 21742
Phone (240) 313-9800

3 Byrkit Dr
Williamsport, MD 21795
Phone (301) 582-1150

Organizations & group practices 3

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1811908023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 249",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426756",
            "telephone_number": "301-714-4100",
            "fax_number": "301-714-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 249",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426756",
            "telephone_number": "301-714-4100",
            "fax_number": "301-714-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERZOUK",
        "first_name": "MARIA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "WV",
            "license": "2181",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "MD",
            "license": "H85851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005936",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.