INTERNAL MEDICINE PRACTICE, P.A.
NPI 1336231950
Clinic/Center - Primary Care in Hagerstown, MD
About Internal Medicine Practice, P.a. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INTERNAL MEDICINE PRACTICE, P.A. (NPI 1336231950) is a healthcare organization registered as a primary care in Hagerstown, Maryland and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through July 21, 2027 and lists Koduah Peprah, Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Internal Medicine Practice, P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Internal Medicine Practice, P.A., which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 21D1102610
Internal Medicine Practice · Hagerstown, MDFrequently 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 Internal Medicine Practice, P.A.'s NPI number?
The NPI number for Internal Medicine Practice, P.A. is 1336231950. It was assigned to this organization in the NPPES registry on September 29, 2006.
Where is Internal Medicine Practice, P.A. located?
Internal Medicine Practice, P.A. is located at 324 E Antietam St Ste 306, Hagerstown, MD 21740. The listed phone number is (301) 739-0240.
What is Internal Medicine Practice, P.A.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Internal Medicine Practice, P.A. enrolled in Medicare?
Yes. Internal Medicine Practice, P.A. is registered in the Medicare PECOS enrollment system.
When is Internal Medicine Practice, P.A.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Maryland, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Internal Medicine Practice, P.A.?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Internal Medicine Practice, P.A.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Internal Medicine Practice, P.A. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 21D1102610) is associated with this NPI, valid through July 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Internal Medicine Practice, P.A. was last updated on February 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Internal Medicine Practice, P.a. · NPI 1336231950
Primary Care organization in Hagerstown, Maryland. Organization record, active in the CMS NPPES registry since September 29, 2006.
## Identity
- **NPI:** 1336231950 (Entity type: Organization)
- **Enumerated:** September 29, 2006
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Koduah Peprah, DIRECTOR
## Practice location
- **Address:** 324 E ANTIETAM ST STE 306, Hagerstown, MD 21740-5768
- **Phone:** (301) 739-0240 · **Fax:** (301) 797-8546
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Maryland, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Internal Medicine) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 6, 2012
- **Other identifiers:** Medicaid 336619700 (MD); Medicare UPIN H71860 (MD); Medicare ID-Type Unspecified 135N (MD)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1336231950) · Data from the CMS NPPES public registry.