Robert Wack, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D0051658 Issued in MD

Practice address

400 W 7TH St
Frederick, MD 21701-4506

Phone

(240) 566-3300

Fax

(240) 566-4872

NPI assigned

Mar 14, 2006

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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robert.wack.1@9462.direct.athenahealth.com

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.

• Carroll County Health Department

  • Public Health or Welfare Agency
  • Westminster, MD
  • NPI 1023558731
  Medicare reassignment NPD
• Carroll County Health Department

  • Public Health or Welfare Agency
  • Westminster, MD
  • NPI 1366711145
  NPD
• Frederick Health Hospital Inc

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

  • Family Medicine Physician
  • Mount Airy, MD
  • NPI 1114771862
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1881662955",
    "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": "240-566-3300",
            "fax_number": "240-566-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506",
            "telephone_number": "240-566-3300",
            "fax_number": "240-566-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACK",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0051658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "245940000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vital Sources, LLC
• John A Vitarello Jr., M.D.
• Katherine Phuong-Nam Vo-Dinh, FNP-BC
• Kruti Vyas, MD
• Gabrielle Wachter
• Allison June Wadding, CRNA
• Christine Michelle Wade, RDH
• Dorine Wade
• Wafo Chiropractic Clinic
• Jennifer Leigh Wager

• Pediatrics Physician in Frederick, MD
• Providers in Frederick, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.