Skip to content

Medical Practices of Antietam LLC

NPI 1194523738ActiveOrganization· Surgery· Frederick, MD

Surgery in Frederick, Maryland, registered in NPPES in March 2025. The authorized official on file is Joshua Repac, Cfo.

Overview

NPI1194523738
StatusActive
Entity typeOrganization
NPI issuedMar 7, 2025
Last updated in NPPESMar 7, 2025
Certified by providerMar 7, 2025

Specialties and licenses

TaxonomyCodeLicenseState
Surgery Primary208600000X——
General Practice208D00000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 4, 2026No match—
New York OMIG · Nov 4, 2026No match—
Ohio Medicaid · Nov 4, 2026No match—
Pennsylvania Medicheck · Nov 4, 2026No match—
Washington HCA · Nov 4, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other Surgery providers in Frederick

All Surgery providers in Maryland →