ATLANTIC GENERAL HOSPITAL CORPORATION — NPI 1205654985 (Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist) in BERLIN, MD)

CMS-1500 Box 24J / 33a • NPI

1205654985

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207RG0100X (CMS 10)

Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist)

Box 32 Service Location & ZIP+4

10231 OLD OCEAN CITY BLVD STE 205, BERLIN, MD, 21811-3568

✓ 9-Digit EDI 837 ZIP+4 (21811-3568)

Practice Phone & Referral Fax

(410) 629-6800

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1205654985 (ATLANTIC GENERAL HOSPITAL CORPORATION) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1205654985` (NPI-2 Organization / Facility)
Provider / Legal Name	ATLANTIC GENERAL HOSPITAL CORPORATION
Plain-English Specialty	Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist) NUCC Code: `207RG0100X` (Internal Medicine, Gastroenterology)
Certifying / Licensing Body	American Board of Internal Medicine — Gastroenterology
Practice Location Address	10231 OLD OCEAN CITY BLVD STE 205, BERLIN, MD, 21811-3568
Practice Telephone / Fax	Tel: (410) 629-6800
Administrative Mailing Address	9733 HEALTHWAY DR, BERLIN, MD, 21811-1156
Enumeration & Last Sync	Enumerated: 2024-10-01 \| CMS Record Updated: 2025-05-30
Authorized Official	STEPHANIE GARY (SVP, Finance/CFO of TidalHealth)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

10231 OLD OCEAN CITY BLVD STE 205, BERLIN, MD, 21811-3568

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Plain-English Taxonomy & CMS Crosswalk (207RG0100X)

What Does Taxonomy Code 207RG0100X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207RG0100X translates to:
"Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 10 (Physician/Gastroenterology) • CMS Code 11 (Physician/Internal Medicine)
Certifying / Accrediting Authority: American Board of Internal Medicine — Gastroenterology
Clinical Scope: Rectal bleeding, hemorrhoids, persistent acid reflux, difficulty swallowing, jaundice (elevated bilirubin), fatty liver disease, or colon cancer screening.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ATLANTIC GENERAL HOSPITAL CORPORATION)

Typical CPT / Diagnostic Procedures:

Screening & Diagnostic Colonoscopy with Polypectomy (CPT 45378–45385)
Esophagogastroduodenoscopy / Upper GI Endoscopy (EGD — CPT 43239)
Hepatic Elastography (FibroScan) & Fractionated Bilirubin/LFT Workup
Internal Hemorrhoid Banding & Anorectal Diagnostic Evaluation

Common Therapeutic Classes:

Proton Pump Inhibitors (Omeprazole, Pantoprazole, Esomeprazole)
H. pylori Quadruple & Triple Eradication Regimens
Mesalamine & Biologic Immunomodulators (Inflammatory Bowel Disease)
Osmotic Laxatives, Rifaximin & Ursodeoxycholic Acid

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207L00000X` — Anesthesiology Plain English: Board-Certified Anesthesiologist & Interventional Pain Specialist	State: N/A \| License: `Verified` \| Primary: Secondary
`207R00000X` — Internal Medicine Plain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)	State: N/A \| License: `Verified` \| Primary: Secondary
`207RG0100X` — Internal Medicine, Gastroenterology Plain English: Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ATLANTIC GENERAL HOSPITAL CORPORATION (NPI #1205654985)