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MEDICAL PRACTICES OF ANTIETAM LLC
NPI 1710854963
Clinic/Center in Hagerstown, MD

Active since October 22, 2025
11110 MEDICAL CAMPUS RD, HAGERSTOWN, MD 21742(301) 790-8000 Get Directions Write a Review

NPPES record last updated: October 22, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Medical Practices Of Antietam Llc NPPES

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

MEDICAL PRACTICES OF ANTIETAM LLC (NPI 1710854963) is a healthcare organization registered as a clinic/center in Hagerstown, Maryland and active in the NPI registry since October 2025. The organization lists Joshua Repac, Cfo, as its authorized official.

NPPES Registry Identity

NPI1710854963
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameMEDICAL PRACTICES OF ANTIETAM LLC
Location Address11110 MEDICAL CAMPUS RDHagerstown, MD 21742-6700
Mailing Address11110 Medical Campus RdHagerstown, MD 21742-6700
Phone(301) 790-8000
Organization SubpartNo
Authorized OfficialJoshua RepacCfo · (301) 790-9351
Enumeration DateOctober 22, 2025
NPPES CertifiedOctober 22, 2025
✔ NPI 1710854963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
11110 MEDICAL CAMPUS RD, Hagerstown, MD 21742
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Medical Practices Of Antietam Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

242

Medicare enrollment records show 242 clinicians reassign Medicare billing to Medical Practices Of Antietam LLC, which bills Medicare for the services they deliver. Of these, 52 practice at this address and 177 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 36

Nurse Practitioner65
Family Practice29
General Surgery21
Obstetrics/Gynecology16
Cardiovascular Disease (Cardiology)11
Urology11
Gastroenterology8
Internal Medicine7
28 other specialties74

Nearest to this location (20)

See all 242
Sarah Anderson, MD
Obstetrics/Gynecology
NPI 1336726702
11110 MEDICAL CAMPUS RD STE 107
Hagerstown, MD 21742
(301) 714-4100
✔ PECOS✔ Accepts MedicareSame address
Pear Enam, M.D.
Gastroenterology
NPI 1780687616
11110 MEDICAL CAMPUS RD STE 246
Hagerstown, MD 21742
(301) 665-4585
✔ PECOS✔ Accepts MedicareSame address
Pauline Hamacher
Nurse Practitioner
NPI 1538053756
11110 MEDICAL CAMPUS RD STE 228
Hagerstown, MD 21742
(301) 733-0022
✔ PECOS✔ Accepts MedicareSame address
Rashid Hanif, M.D.
Gastroenterology
NPI 1285637116
11110 MEDICAL CAMPUS RD STE 246
Hagerstown, MD 21742
(301) 665-4585
✔ PECOS✔ Accepts MedicareSame address
Alina Huneke
Nurse Practitioner
NPI 1770066482
11110 MEDICAL CAMPUS RD STE 147
Hagerstown, MD 21742
(301) 790-8750
✔ PECOS✔ Accepts MedicareSame address
Jeffrey Johnson, MD
Urology
NPI 1730684903
11110 MEDICAL CAMPUS RD STE 228
Hagerstown, MD 21742
(301) 733-0022
✔ PECOS✔ Accepts MedicareSame address
Ariel Lim-Sharpe, DO
Family Practice
NPI 1760122592
11110 MEDICAL CAMPUS RD STE 200
Hagerstown, MD 21742
(301) 790-9244
✔ PECOS✔ Accepts MedicareSame address
Eric Maiorino, M.D.
Plastic and Reconstructive Surgery
NPI 1174888606
11110 MEDICAL CAMPUS RD STE 241
Hagerstown, MD 21742
(301) 714-4460
✔ PECOS✔ Accepts MedicareSame address
Brian Mckinnon, MD
Otolaryngology
NPI 1316945819
11110 MEDICAL CAMPUS RD STE 250
Hagerstown, MD 21742
(301) 665-4960
✔ PECOS✔ Accepts MedicareSame address
Paula Nguyen
Family Practice
NPI 1689201576
11110 MEDICAL CAMPUS RD STE 200
Hagerstown, MD 21742
(301) 714-4400
✔ PECOS✔ Accepts MedicareSame address
Sylvester Paulasir, M.D.
General Surgery
NPI 1689932998
11110 MEDICAL CAMPUS RD STE 143
Hagerstown, MD 21742
(301) 714-4350
✔ PECOS✔ Accepts MedicareSame address
Mary Romanic, M.D.
Rheumatology
NPI 1467554097
11110 MEDICAL CAMPUS RD STE 150
Hagerstown, MD 21742
(301) 665-4825
✔ PECOS✔ Accepts MedicareSame address
Alondra Black
Certified Nurse Midwife (CNM)
NPI 1710740162
11110 MEDICAL CAMPUS RD STE 107
Hagerstown, MD 21742
(301) 714-4100
✔ PECOS✔ Accepts MedicareSame address
Elizabeth Taylor
Certified Nurse Midwife (CNM)
NPI 1912772674
11110 MEDICAL CAMPUS RD STE 107
Hagerstown, MD 21742
(301) 714-4100
✔ PECOS✔ Accepts MedicareSame address
Sabrina Meftali
Endocrinology
NPI 1801336466
11110 MEDICAL CAMPUS RD STE 108
Hagerstown, MD 21742
(301) 714-4041
✔ PECOS✔ Accepts MedicareSame address
Ijeoma Ifeanyi-Nwanze, MD
Pain Management
NPI 1205272754
11110 MEDICAL CAMPUS RD STE 225
Hagerstown, MD 21742
(301) 665-4720
✔ PECOS✔ Accepts MedicareSame address
John Maggioncalda, MD
Urology
NPI 1346239472
11110 MEDICAL CAMPUS RD STE 228
Hagerstown, MD 21742
(301) 733-0022
✔ PECOS✔ Accepts MedicareSame address
Victor Anyangwe, M.D.
Orthopedic Surgery
NPI 1295020220
11110 MEDICAL CAMPUS RD STE 205
Hagerstown, MD 21742
(301) 302-0503
✔ PECOS✔ Accepts MedicareSame address
Andreas Kaikis, DPM
Podiatry
NPI 1811384530
11110 MEDICAL CAMPUS RD STE 205
Hagerstown, MD 21742
(301) 665-4950
✔ PECOS✔ Accepts MedicareSame address
Jamie Hittman, MD
Pathology
NPI 1609372143
11110 MEDICAL CAMPUS RD STE 230
Hagerstown, MD 21742
(301) 665-4900
✔ PECOS✔ Accepts MedicareSame address
See all 242 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Medical Practices Of Antietam LLC's NPI number?

The NPI number for Medical Practices Of Antietam LLC is 1710854963. It was assigned to this organization in the NPPES registry on October 22, 2025.

Where is Medical Practices Of Antietam LLC located?

Medical Practices Of Antietam LLC is located at 11110 Medical Campus Rd, Hagerstown, MD 21742. The listed phone number is (301) 790-8000.

What is Medical Practices Of Antietam LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Medical Practices Of Antietam LLC enrolled in Medicare?

Yes. Medical Practices Of Antietam LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Medical Practices Of Antietam LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 242 clinicians in 36 Medicare specialties reassign their Medicare billing to Medical Practices Of Antietam LLC. 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. The largest specialties are Nurse Practitioner (65), Family Practice (29) and General Surgery (21). Of these, 52 practice at this address and 177 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Medical Practices Of Antietam LLC was last updated on October 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.