MEDICAL PRACTICES OF ANTIETAM LLC
NPI 1033990866
Clinic/Center - Ambulatory Surgical in Hagerstown, MD
NPI Status: Active since October 09, 2023
Contact Information
11110 MEDICAL CAMPUS RD STE 228
HAGERSTOWN, MD
ZIP 21742
Phone: (301) 733-0022
- Organization
- Clinic/Center
- Ambulatory Surgical
- CLIA Number: 21D2281566
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-17-2027
About MEDICAL PRACTICES OF ANTIETAM LLC
This page provides the complete NPI Profile along with additional information for Medical Practices Of Antietam Llc, a provider established in Hagerstown, Maryland operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1033990866 assigned on October 2023. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Joshua Repac (Cfo)
- NPI
- 1033990866
- Provider Name
- MEDICAL PRACTICES OF ANTIETAM LLC
- Entity Type
- Organization
- Location Address
- 11110 MEDICAL CAMPUS RD STE 228 HAGERSTOWN, MD 21742
- Location Phone
- (301) 733-0022
- Mailing Address
- 11110 MEDICAL CAMPUS RD STE 228 HAGERSTOWN, MD 21742
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-09-2023
- Last Update Date
- 10-09-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Ambulatory Surgical
- Taxonomy Code
- 261QA1903X
- Type
- Ambulatory Health Care Facilities
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 21D2281566
- Facility Type
- Physician Office
- Certificate Effective Date
- July 18, 2025
- Certificate Expiration Date
- July 17, 2027
- Laboratory Director
- DR. MICHAEL J. O'DONOGHUE
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Medical Practices Of Antietam Llc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1033990866, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
HAGERSTOWN, MD 21742
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1033990866, enumerated as an "organization" on October 09, 2023.
The provider is located at 11110 MEDICAL CAMPUS RD STE 228 HAGERSTOWN, MD 21742 and the phone number is (301) 733-0022.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.
