Thomas Ptak (NPI# 1467436394, PAC ID# 9537052766) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1467436394 |
| PAC ID by PECOS | 9537052766 |
| Professional Enrollment ID | I20171116001033 |
| Full Name | Thomas Ptak |
| Organization Legal Name | UNIVERSITY OF MARYLAND DIAGNOSTIC IMAGING SPECIALISTS, PA |
| Address |
5 Garrett Ave La Plata MD 20646-5960 |
| Phone Number | 3016094000 |
| Gender | M |
| Credential | MD |
| Medical School | ALBANY MEDICAL COLLEGE OF UNION UNIVERSITY |
| Graduation Year | 1990 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 7719873298 |
| Number of Group Practice Members | 75 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 210002 | UNIVERSITY OF MARYLAND MEDICAL CENTER |
| 210003 | UNIVERSITY OF MD PRINCE GEORGE'S HOSPITAL CTR |
| 210037 | UNIVERSITY OF MD SHORE MEDICAL CENTER AT EASTON |
| 210001 | MERITUS MEDICAL CENTER |
| 210011 | SAINT AGNES HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 22 S Greene St, Department of Radiology, Baltimore, MD 21201-1544 | 4103285700 | UNIVERSITY OF MARYLAND DIAGNOSTIC IMAGING SPECIALISTS, PA |
| 7600 Dwight Dr, Bethesda, MD 20817-2027 | 4103283477 | UNIVERSITY OF MARYLAND DIAGNOSTIC IMAGING SPECIALISTS, PA |
| 5 Garrett Ave, La Plata, MD 20646-5960 | 3016094000 | UNIVERSITY OF MARYLAND DIAGNOSTIC IMAGING SPECIALISTS, PA |
| Organization Legal Name | UNIVERSITY OF MARYLAND DIAGNOSTIC IMAGING SPECIALISTS, PA |
| Physicians | 20 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nicholas Charles Fasano | Diagnostic Radiology | University of Maryland Diagnostic Imaging Specialists, Pa | 222 Deer Trail Rd, Spring Grove, PA 17362-8603 |
| Azar P Dagher | Diagnostic Radiology | University of Maryland Diagnostic Imaging Specialists, Pa | 7600 Dwight Dr, Bethesda, MD 20817-2027 |
| Kathleen G Gordon | Diagnostic Radiology | University of Maryland Diagnostic Imaging Specialists, Pa | 7300 Van Dusen Rd, Laurel, MD 20707-9463 |
| Kim M Callwood | Diagnostic Radiology | University of Maryland Diagnostic Imaging Specialists, Pa | 7300 Van Dusen Rd, Laurel, MD 20707-9463 |
| Matthew Peter Dattwyler | Diagnostic Radiology | University of Maryland Diagnostic Imaging Specialists, Pa | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Shavitri Ananda Mahendiran | Diagnostic Radiology | University of Maryland Diagnostic Imaging Specialists, Pa | 3001 Hospital Dr, Cheverly, MD 20785-1189 |
| Charles E Hunter | Diagnostic Radiology | University of Maryland Diagnostic Imaging Specialists, Pa | 7300 Van Dusen Rd, Laurel, MD 20707-9463 |
| Vasken Dilsizian | Nuclear Medicine | University of Maryland Diagnostic Imaging Specialists, Pa | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Ifechi Natalie Ukeh | Interventional Radiology | University of Maryland Diagnostic Imaging Specialists, Pa | 3001 Hospital Dr, Cheverly, MD 20785-1189 |
| Thorsten Roger Fleiter | Diagnostic Radiology | University of Maryland Diagnostic Imaging Specialists, Pa | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Street Address |
5 GARRETT AVE |
| City | LA PLATA |
| State | MD |
| Zip | 20646-5960 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chelsea Dawn Hughes | Physician Assistant | Mdics At Civista LLC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Sudhakar Vl Devathi | Hospitalist | Mdics At Civista LLC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Shalender Saini | Hospitalist | Mdics At Civista LLC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| James Tzeng | Thoracic Surgery | Surgical Associates Chartered | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Vijayasimha Pothula | Anesthesiology | Maryland Anesthesia and Pain Management Services PC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Rachel P Stewart Johnson | Certified Registered Nurse Anesthetist (crna) | Maryland Anesthesia and Pain Management Services PC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Robert John Wagner Jr. | General Surgery | Surgical Associates Chartered | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Seid Aminu | Hospitalist | Mdics At Civista LLC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Darrell E Lewis | Anesthesiology | Maryland Anesthesia and Pain Management Services PC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Matthew Peter Dattwyler | Diagnostic Radiology | University of Maryland Diagnostic Imaging Specialists, Pa | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Frank Alfano | Chiropractic | 203 Centennial St, Suite 105, La Plata, MD 20646-2741 | |
| Megan N Shroyer | Physician Assistant | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Kirandeep Kaur | Internal Medicine | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Taana P Viviano | Internal Medicine | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Farhana B Syed | General Practice | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Juachi I Mbah | Nurse Practitioner | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Michael J Warren | Nurse Practitioner | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Ted Howe | Pediatric Medicine | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Josjin Vazhappilly | Internal Medicine | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Virginia A Noftsier | Physician Assistant | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Find all physicians in zip 20646 | |||
| City | LA PLATA |
| Zip Code | 20646 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | LA PLATA + DIAGNOSTIC RADIOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.