NPIMap

Individual provider Active NPI

Jacob Wynes, DPM

  • Foot Surgery Podiatrist
  • Baltimore, MD
National Provider Identifier
1083840524
Registry record updated Mar 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
O1555 Issued in MD
Practice address
2200 Kernan Drive
Baltimore, MD 21207
Phone
(410) 448-7112
NPI assigned
Jun 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X O1555 MD Primary

Addresses

Primary practice location

2200 Kernan Drive
Baltimore, MD 21207

Mailing address

2200 Kernan Drive
Baltimore, MD 21207
Phone (410) 448-7112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141016000272 MD Practitioner - Podiatry 9931320934 Reassigns benefits to 2 organizations
I20141017000676 DC Practitioner - Podiatry 9931320934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians
Medical Rehabilitation Systems LLCGroup PAC ID 4486547163, 71 clinicians
Amber Hill Physical Therapy IncGroup PAC ID 8527963917, 336 clinicians
University of Maryland Orthopaedic Associates PAGroup PAC ID 0042108722, 68 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

12 Newport Dr
Forest Hill, MD 21050-1758

12580 National Pike
Grantsville, MD 21536-3310
Phone (301) 895-5793

187 Thomas Johnson Dr
Frederick, MD 21702-4503

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-6704

2200 Kernan Dr
Baltimore, MD 21207-6665
Phone (410) 328-6704

Hospital & facility affiliations

  • Bayada Home Health Care, Inc. Home health agency, Towson, MD, CCN 217101
  • University of MD Medical Center Midtown Campus Hospital, Baltimore, MD, CCN 210038
  • University of Maryland Medical Center Hospital, Baltimore, MD, CCN 210002
  • Umd Rehabilitation & Orthopaedic Institute Hospital, Baltimore, MD, CCN 210058
  • University of MD Shore Medical Center at Easton Hospital, Easton, MD, CCN 210037

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue537
Removal of skin lesions1-10
Removal of nail tissue34
Removal or shaving of skin growth56
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
O1555MDMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Orthopaedic Associates PA CurrentSince Aug 3, 2014 Accepting new patients
University of Maryland Orthopaedic Associates P a Foot Surgery CurrentSince Aug 3, 2014 Accepting new patients
University of Maryland Orthopaedic Trauma Associates, PA CurrentSince Aug 3, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

226 Schilling Cir
Ste 170
Hunt Valley, MD 21031
Phone (240) 315-6800

2200 Kernan Dr
Woodlawn, MD 21207
Phone (410) 448-2500

Interoperability endpoints

  • Direct secure messaging: jwynes102780@direct.umm.edu
  • Direct secure messaging: drwynes@direct.meditouchehr.com

Organizations & group practices 7

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 10

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": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1083840524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 KERNAN DRIVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21207",
            "telephone_number": "410-448-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 KERNAN DRIVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21207",
            "telephone_number": "410-448-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNES",
        "first_name": "JACOB",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-10",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MD",
            "license": "O1555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.