NPIMap

Individual provider Active NPI

Vasant Datta, M.D.

  • Family Medicine Physician
  • Hagerstown, MD
National Provider Identifier
1982666913
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0018019 Issued in MD
Practice address
340 Mill St
Hagerstown, MD 21740-6138
Phone
(301) 739-7100
Fax
(301) 739-5925
NPI assigned
Apr 5, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0018019 MD Primary

Addresses

Primary practice location

340 Mill St
Hagerstown, MD 21740-6138

Mailing address

PO Box 599
Funkstown, MD 21734-0599
Phone (301) 739-7100

Other identifiers 2

IdentifierTypeStateIssuer
876319OtherMDMAMSI
41251801OtherMDBC/BC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, WV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101123001004 MD Practitioner - Family Practice 3971499070 Reassigns benefits to 1 organization
I20111206000461 WV Practitioner - Family Practice 3971499070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1963
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1263 S George St
Charles Town, WV 25414-4384
Phone (386) 313-5287

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rinehart Institute, PLLC Current Accepting new patients
Blue Ridge Nursing, LLC PastSince Oct 1, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Willow Tree Healthcare CenterCharles Town, WV, CCN 515156 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2021
Oct 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Blue Ridge Nursing, LLC

    dba Willow Tree Healthcare Center

    • Nursing Facility/Intermediate Care Facility
    • Charles Town, WV
    • NPI 1346449451

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1982666913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 599",
            "city": "FUNKSTOWN",
            "state": "MD",
            "postal_code": "217340599",
            "telephone_number": "301-739-7100",
            "fax_number": "301-739-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MILL ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406138",
            "telephone_number": "301-739-7100",
            "fax_number": "301-739-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTA",
        "first_name": "VASANT",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0018019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "876319",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BC",
            "identifier": "41251801",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.