ROY D CHISHOLM III M.D.
NPI 1275550279
Surgery in Cumberland, MD

Q: What is Roy Chisholm's NPI number?

The NPI number for Roy Chisholm is 1275550279. It was assigned to this individual provider in the NPPES registry on July 16, 2006.

Q: What is Roy Chisholm's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Roy Chisholm was last updated on March 13, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 16, 2006PECOS EnrolledAccepts Medicare Assignment

86.92/100

CMS Quality Rating

12502 WILLOWBROOK RD, SUITE 500, CUMBERLAND, MD 21502(301) 724-8847(301) 724-7016 Get Directions Write a Review

NPPES record last updated: March 13, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Roy D Chisholm Iii M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROY D CHISHOLM III M.D. (NPI 1275550279) is an individual surgery provider in Cumberland, Maryland, licensed in Maryland (D34362) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Western Maryland Regional Medical Center, and is a graduate of University Of Kentucky College Of Medicine (1984).

NPPES Registry Identity

NPI1275550279

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameROY D CHISHOLM IIICredential: M.D.

Location Address12502 WILLOWBROOK RD, SUITE 500Cumberland, MD 21502-6491

Mailing Address12502 Willowbrook Rd, Suite 500Cumberland, MD 21502-6491 · (301) 724-8847 · Fax (301) 724-7016

Phone(301) 724-8847

Fax(301) 724-7016

Sole ProprietorYes

Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 1984

Enumeration DateJuly 16, 2006

Last NPPES UpdateMarch 13, 2024

✔ NPI 1275550279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in MD · D34362

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

12502 WILLOWBROOK RD, Cumberland, MD 21502

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Other Identifiers 6

Other0126225000WV · Wv Medicaid

Medicaid531441100MD

Other425241MD · Mamsi

Other1344505MD · United Healthcare

Other424535MD · Carefirst Blue Shield

Other2530906005MD · Cigna

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Roy D Chisholm Iii M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2668519414

PECOS Enrollment IDI20091027000586

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 17

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

101 services86 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

55 services55 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

43 services43 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

38 services36 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

32 services20 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

30 services28 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

27 services27 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

26 services22 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

21 services21 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

16 services16 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

15 services15 patients

Removal of gallbladder using an endoscope 47562

This procedure, known as endoscopic gallbladder removal, involves a surgeon using a special tool called an endoscope to remove your gallbladder through small incisions. It's typically done to treat gallstones and related complications. It's a less invasive method, often leading to quicker recovery.

15 services15 patients

Partial removal of breast 19301

A partial removal of the breast, also known as a lumpectomy, involves taking out a portion of the breast tissue to eliminate concerning cells. It's typically performed when the problem area is limited in size. This procedure helps to preserve most of the breast's appearance while aiming to remove all the unhealthy cells.

13 services13 patients

Imaging of lymph nodes during surgery 38900

Imaging of lymph nodes during surgery involves taking detailed pictures of your lymph nodes to help surgeons see and assess them in real-time. This procedure can aid in detecting disease, guiding treatment, and improving surgical precision.

13 services13 patients

Biopsy or removal of deep lymph nodes of underarm 38525

A biopsy or removal of deep underarm lymph nodes is a procedure where a small sample of lymph node tissue is taken for testing. This helps in diagnosing or ruling out conditions like infections or cancers. It involves a small incision and is typically done under local or general anesthesia.

12 services12 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

11 services11 patients

Repair of groin hernia using an endoscope 49650

This procedure involves the use of an endoscope, a thin tube with a camera, to repair a hernia in the groin area. The surgeon makes small incisions, inserts the endoscope, and uses special tools to fix the hernia. This minimally invasive technique often results in quicker recovery times.

11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Western Maryland Regional Medical Center

Acute Care Hospitals · Cumberland, MD

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number210027

Location12500 Willowbrook RoadCumberland, MD 21502 · Allegany County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21502 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$89.75 typical visit price

range $57.99 – $175.57

Typical copayment $22.43 (range $14.49 – $43.89)

Most-billed visit code 99203

Established Patient

$72.23 typical visit price

range $18.66 – $143.02

Typical copayment $18.05 (range $4.66 – $35.75)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.92/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

70.08

Promoting Interoperability

100

Improvement Activities

Cost

80.8

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each A5056

DME-Orthotic Devices · category DF010N

2 suppliers17 claims340 services$4.26 avg. paid by Medicare

Skin barrier, wipes or swabs, each A5120

DME-Orthotic Devices · category DF010N

4 suppliers17 claims425 services$0.20 avg. paid by Medicare

Transport chair, adult size, patient weight capacity up to and including 300 pounds E1038

DME-Other DME · category DE000N

1 supplier14 claims14 services$9.20 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARK F. WILT P. A.

Physician Assistant

12502 WILLOWBROOK RD, SUITE 470
CUMBERLAND, MD 21502

Allegany County (240) 964-8724

SHANNON SPRENKLE CRNP

Nurse Practitioner

12502 WILLOWBROOK RD, SUITE 280
CUMBERLAND, MD 21502

Allegany County (240) 964-8750

KRISTEN DAWN EWING PA-C

Physician Assistant (Medical)

12502 WILLOWBROOK RD
CUMBERLAND, MD 21502

Allegany County (240) 964-8740

JACOB MULLAN FNP

Nurse Practitioner

12502 WILLOWBROOK RD
CUMBERLAND, MD 21502

Allegany County (240) 964-8944

WESTERN MARYLAND HEALTH SYSTEM CORPORATION

Dietitian, Registered

12502 WILLOWBROOK RD, SUITE 300
CUMBERLAND, MD 21502

Allegany County (240) 964-8342

CARMEN RACHAL REGISTERED DIETITIAN

Dietitian, Registered

12502 WILLOWBROOK RD
CUMBERLAND, MD 21502

Allegany County (240) 964-2310

EMILY TEETS NP

Nurse Practitioner

12502 WILLOWBROOK RD
CUMBERLAND, MD 21502

Allegany County (240) 964-7000

JEAN H RUIZ NP

Nurse Practitioner (Psychiatric/Mental Health)

12502 WILLOWBROOK RD, STE 380
CUMBERLAND, MD 21502

Allegany County (240) 964-8585

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roy Chisholm's NPI number?

The NPI number for Roy Chisholm is 1275550279. It was assigned to this individual provider in the NPPES registry on July 16, 2006.

Where is Roy Chisholm located?

Roy Chisholm practices at 12502 Willowbrook Rd Suite 500, Cumberland, MD 21502. The listed phone number is (301) 724-8847.

What is Roy Chisholm's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Roy Chisholm enrolled in Medicare?

Yes. Roy Chisholm is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Roy Chisholm accept?

Health plans from CareSource list Roy Chisholm as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Roy Chisholm affiliated with any hospitals?

According to CMS data, Roy Chisholm is affiliated with Western Maryland Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Roy Chisholm was last updated on March 13, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.