Organization Active NPI

A. Jerry Friedman, M.D., P.a.

  • Medical Specialty Clinic/Center
  • Rockville, MD
National Provider Identifier
1083869556
Registry record updated Nov 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
D0026753 Issued in MD
Legal business name
A. JERRY FRIEDMAN, M.D., P.A.
Practice address
9715 Medical Center Dr
Suite 531
Rockville, MD 20850-3320
Phone
(301) 251-1771
NPI assigned
Nov 24, 2008
Last updated
Nov 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2008

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

Authorized official

Name
Dr. Alan Jerry Friedman, M.D.NPI 1659487148
Title
President
Phone
(301) 251-1771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X D0026753 MD Primary

Addresses

Primary practice location

9715 Medical Center Dr
Suite 531
Rockville, MD 20850-3320

Mailing address

9715 Medical Center Dr
Suite 531
Rockville, MD 20850-3320
Phone (301) 251-1771

Other identifiers 1

IdentifierTypeStateIssuer
367221200MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081110000436 DC Part B Supplier - Clinic/Group Practice 9234298977 Receives reassigned benefits from 1 practitioner
Practice locations: Rockville, MD

National Provider Directory

National Provider Directory

Locations

15005 Shady Grove Rd
Ste 310
Rockville, MD 20850
Phone (301) 251-1771

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227484800000",
    "number": "1083869556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9715 MEDICAL CENTER DR",
            "address_2": "SUITE 531",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503320",
            "telephone_number": "301-251-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9715 MEDICAL CENTER DR",
            "address_2": "SUITE 531",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503320",
            "telephone_number": "301-251-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A. JERRY FRIEDMAN, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-24",
        "last_updated": "2008-11-24",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "JERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-251-1771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MD",
            "license": "D0026753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "367221200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.