Individual provider Active NPI

Jennifer Jean Haagensen, D.O.

  • Neurology Physician
  • Baltimore, MD
National Provider Identifier
1043658651
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
OT-015353 Issued in PA
Practice address
16 S Eutaw St
Baltimore, MD 21201-1606
Phone
(215) 762-7698
NPI assigned
Jun 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X OT-015353 PA Primary

Addresses

Primary practice location

16 S Eutaw St
Baltimore, MD 21201-1606

Mailing address

16 S Eutaw St
Baltimore, MD 21201-1606
Phone (410) 328-6483

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
I20191003000080 MD Practitioner - Neurology 6103125380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Philadelphia College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

9000 Franklin Square Dr
Baltimore, MD 21237-3901
Phone (443) 777-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT-015353PAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Mar 1, 2023 Accepting new patients
Medstar Medical Group II LLC CurrentSince Mar 1, 2023 Accepting new patients

Locations

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

9103 Franklin Square Dr
Ste 302
Rosedale, MD 21237
Phone (410) 248-6300

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

Organizations & group practices 2

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 3

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": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1043658651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 S EUTAW ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011606",
            "telephone_number": "410-328-6483",
            "fax_number": "410-328-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 S EUTAW ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011606",
            "telephone_number": "215-762-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAGENSEN",
        "first_name": "JENNIFER",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-06",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "OT-015353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.