Individual provider Active NPI

Jacalyn Gordon Ginsberg, DO

  • Pediatric Adolescent Medicine Physician
  • Severna Park, MD
National Provider Identifier
1053383117
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
H51249 Issued in MD
Practice address
844 Ritchie Hwy
Suite 206
Severna Park, MD 21176
Phone
(410) 647-8306
Fax
(410) 315-8444
NPI assigned
Feb 3, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X H51249 MD
Pediatric Adolescent Medicine Physician 2080A0000X H51249 MD Primary

Addresses

Primary practice location

844 Ritchie Hwy
Suite 206
Severna Park, MD 21176

Mailing address

844 Ritchie Hwy
Suite 206
Severna Park, MD 21176
Phone (410) 647-8306

Other identifiers 6

IdentifierTypeStateIssuer
H51249OtherMD LICENSE #
OH64OtherBS
08795OtherPHN
11120OtherBS POS
T5930002OtherBLUE CHOICE
T5930002OtherBSFED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
H51249MDMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jacalyn.ginsburg.1@7265.direct.athenahealth.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1053383117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 RITCHIE HWY",
            "address_2": "SUITE 206",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "21176",
            "telephone_number": "410-647-8306",
            "fax_number": "410-315-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 RITCHIE HWY",
            "address_2": "SUITE 206",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "21176",
            "telephone_number": "410-647-8306",
            "fax_number": "410-315-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINSBERG",
        "first_name": "JACALYN",
        "middle_name": "GORDON",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "H51249",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MD",
            "license": "H51249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE #",
            "identifier": "H51249",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "OH64",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHN",
            "identifier": "08795",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS POS",
            "identifier": "11120",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "T5930002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSFED",
            "identifier": "T5930002",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.