Individual provider Active NPI

Jason Charles Stanford, P.A.-C

  • Surgical Physician Assistant
  • Germantown, MD
National Provider Identifier
1003093667
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C0002208 Issued in MD
Practice address
19466 Caravan Dr
Germantown, MD 20874-6220
Phone
(214) 227-2457
Fax
(214) 764-0880
NPI assigned
Jan 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X C0002208 MD Primary

Addresses

Primary practice location

19466 Caravan Dr
Germantown, MD 20874-6220

Mailing address

8110 Maple Lawn Blvd Ste 235
Fulton, MD 20759-2694
Phone (301) 340-8339

Other practice location 1

61 Thomas Johnson Dr
Frederick, MD 21702-4301
Phone (301) 663-6171

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jason.stanford.p1@direct.cwcare.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100416000796 MD Practitioner - Physician Assistant 0042347312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Womens Care LLCGroup PAC ID 4880582741, 281 clinicians

Practice addresses (Care Compare)

61 Thomas Johnson Dr
Frederick, MD 21702-4301
Phone (301) 663-6171

Hospital & facility affiliations

  • Frederick Health Hospital Hospital, Frederick, MD, CCN 210005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Women'S Care, L.L.C. Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Stanford Surgical Services LLC Surgical PastSince Jul 10, 2022 Accepting new patients

Locations

61 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 663-6171

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

8110 Maple Lawn Blvd
Ste 235
Fulton, MD 20759

5801 Postal Rd
Unit 81310
Cleveland, OH 44181

Interoperability endpoints

  • Direct secure messaging: jason.stanford.p1@direct.cwcare.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1003093667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 MAPLE LAWN BLVD STE 235",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592694",
            "telephone_number": "301-340-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19466 CARAVAN DR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208746220",
            "telephone_number": "214-227-2457",
            "fax_number": "214-764-0880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "61 Thomas Johnson Dr",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024301",
            "country_code": "US",
            "telephone_number": "301-663-6171",
            "fax_number": "301-695-4469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "JASON",
        "middle_name": "CHARLES",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-25",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0002208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jason.stanford.p1@direct.cwcare.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "61 Thomas Johnson Dr",
            "city": "Frederick",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217024301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

Verify at the official NPI Registry.