Individual provider Active NPI

Maniraj Jeyaraju, MD

  • Family Medicine Physician
  • Columbia, MD
National Provider Identifier
1053056044
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0102572 Issued in MD
Practice address
5500 Knoll North Dr Ste 370
Columbia, MD 21045-2393
Phone
(410) 837-2050
NPI assigned
May 3, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NC
Family Medicine Physician 207Q00000X 2024-00627 NC
Family Medicine Physician 207Q00000X D0102572 MD Primary

Addresses

Primary practice location

5500 Knoll North Dr Ste 370
Columbia, MD 21045-2393

Mailing address

590 Manning Dr
Chapel Hill, NC 27599-6119
Phone (984) 974-0210

Other practice location 1

590 Manning Dr
Chapel Hill, NC 27599-6119
Phone (984) 974-0210

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
I20250821002477 MD Practitioner - Family Practice 8527445220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Maryland School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chase Brexton Health Services IncGroup PAC ID 5395644835, 119 clinicians

Practice addresses (Care Compare)

1111 N Charles St
Baltimore, MD 21201-5505
Phone (410) 837-2050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0102572MDMDFamily Medicine Physician
2024-00627NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chase Brexton Health Services, Inc. CurrentSince Jul 14, 2025 Accepting new patients
Chase Brexton Health Services, Inc. CurrentSince Jul 14, 2025 Accepting new patients

Locations

1111 N Charles St
Baltimore, MD 21201
Phone (410) 486-5991

5500 Knoll North Dr
Ste 370
Columbia, MD 21045
Phone (410) 884-7831

200 Hospital Dr
Ste 300
Glen Burnie, MD 21061

Interoperability endpoints

  • Direct secure messaging: mjeyaraju412463@directhisp.wakemed.org
  • Direct secure messaging: mjeyaraju873624@direct.unc.nchie.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1053056044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275996119",
            "telephone_number": "984-974-0210",
            "fax_number": "919-966-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 KNOLL NORTH DR STE 370",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452393",
            "telephone_number": "410-837-2050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "590 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275996119",
            "country_code": "US",
            "telephone_number": "984-974-0210",
            "fax_number": "919-966-6216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEYARAJU",
        "first_name": "MANIRAJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-03",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2024-00627",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0102572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.