Stefan Anthony Eltgroth, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

DOO53622 Issued in MD

Practice address

Usameddac
2480 Llewellyn Ave.
Fort George G. Meade, MD 20755

Phone

(410) 278-5475

NPI assigned

Feb 13, 2007

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Doctors' Billing & Management Solutions, Inc

  • Point of Service
  • Glen Burnie, MD
  • NPI 1578516183
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Physicians' House Calls

  • Contractor
  • Glen Burnie, MD
  • NPI 1346315827
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1942342928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE",
            "city": "FORT GEORGE G MEADE",
            "state": "MD",
            "postal_code": "207555800",
            "telephone_number": "410-278-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USAMEDDAC",
            "address_2": "2480 LLEWELLYN AVE.",
            "city": "FORT GEORGE G. MEADE",
            "state": "MD",
            "postal_code": "20755",
            "telephone_number": "410-278-5475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELTGROTH",
        "first_name": "STEFAN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "DOO53622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Dial, DPT
• Britttany Elaine Dietz, PTA
• Kathleen M Donahue, D.O.
• Amber Doty
• Emmanuel J Easterling
• Jainava Seguritan Emanuel
• Garth Evers, PT
• Leslie Lisa Farrington, REGISTERED NURSE
• Nicole Ferris
• Nicole Fetter, MSW, LISW

• Internal Medicine Physician in Fort George G. Meade, MD
• Providers in Fort George G. Meade, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.