Individual provider Active NPI

Jacob Cherian, M.D.

  • Internal Medicine Physician
  • Columbia, MD
National Provider Identifier
1003973637
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D50973 Issued in MD
Practice address
5450 Knoll North Dr
Columbia, MD 21045-2300
Phone
(410) 964-5311
Fax
(410) 964-8578
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D50973 MD Primary

Addresses

Primary practice location

5450 Knoll North Dr
Columbia, MD 21045-2300

Mailing address

6286 Tufted Moss
Columbia, MD 21045-4534
Phone (410) 309-0452

Other identifiers 1

IdentifierTypeStateIssuer
780011800MedicaidMD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041112000058 MD Practitioner - Internal Medicine 9436113255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Maryland School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amber Hill Physical Therapy IncGroup PAC ID 8527963917, 336 clinicians

Practice addresses (Care Compare)

10910 Little Patuxent Pkwy
Suite 105R
Columbia, MD 21044-3081
Phone (410) 964-5311

187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D50973MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
University of Maryland Pediatric Associates, PA Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003973637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6286 TUFTED MOSS",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210454534",
            "telephone_number": "410-309-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 KNOLL NORTH DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452300",
            "telephone_number": "410-964-5311",
            "fax_number": "410-964-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERIAN",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D50973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "780011800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.