Medical Practices of Antietam, LLC
NPI 1558430843ActiveOrganization· General Practice· Hagerstown, MD
General Practice in Hagerstown, Maryland, registered in NPPES in November 2006. The authorized official on file is Joshua Repac, Cfo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1558430843 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 8, 2006 |
| Last updated in NPPES | Oct 26, 2022 |
| Certified by provider | Oct 26, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (PA) |
|---|
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