Individual provider Active NPI

Stephen James McKenna, MD, MBA, FACS

  • Surgery Physician
  • Frederick, MD
National Provider Identifier
1982665147
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D0031422 Issued in MD
Practice address
187 Thomas Johnson Dr
Suite 7
Frederick, MD 21702-4503
Phone
(240) 457-4605
Fax
(240) 457-4631
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X D0031422 MD Primary

Addresses

Primary practice location

187 Thomas Johnson Dr
Suite 7
Frederick, MD 21702-4503

Mailing address

187 Thomas Johnson Dr
Suite 7
Frederick, MD 21702-4503
Phone (240) 457-4605

Other identifiers 1

IdentifierTypeStateIssuer
483881500MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100920000011 MD Practitioner - General Surgery 1456476076 Reassigns benefits to 1 organization
I20110714000637 DC Practitioner - General SurgeryPractitioner - Other (Physician) 1456476076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Howard University College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

187 Thomas Johnson Dr
Suite 7
Frederick, MD 21702-4383
Phone (240) 457-4605

Hospital & facility affiliations

  • Frederick Health Hospital Hospital, Frederick, MD, CCN 210005
  • Umd Upper Chesapeake Medical Center Hospital, Bel Air, MD, CCN 210049

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)16
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0031422MDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen J McKenna, LLC Surgery CurrentSince Jun 6, 2010 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
McKenna General Medical, LLC PastSince Aug 16, 2011 Accepting new patients

Locations

187 Thomas Johnson Dr
Ste 7
Frederick, MD 21702
Phone (240) 457-4605

7211 Bank Ct
Ste 200
Frederick, MD 21703
Phone (240) 457-4605

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

915 Toll House Ave
Ste 303
Frederick, MD 21701
Phone (301) 698-5550

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

Interoperability endpoints

  • Direct secure messaging: stephenmckenna@mckennasurgicalassociates.ssdirect.aprima.com

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 2

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1982665147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 THOMAS JOHNSON DR",
            "address_2": "SUITE 7",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024503",
            "telephone_number": "240-457-4605",
            "fax_number": "240-457-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 THOMAS JOHNSON DR",
            "address_2": "SUITE 7",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024503",
            "telephone_number": "240-457-4605",
            "fax_number": "240-457-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "STEPHEN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "MD, MBA, FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0031422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "483881500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.