Individual provider Active NPI

Jennifer Rose Tawil, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1093069460
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C07539 Issued in MD
Practice address
2700 Quarry Lake Dr Ste 300
Baltimore, MD 21209-3746
Phone
(410) 377-8900
NPI assigned
Nov 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 017656 NY
Physician Assistant 363A00000X PA9106854 FL
Physician Assistant 363A00000X C07539 MD Primary

Addresses

Primary practice location

2700 Quarry Lake Dr Ste 300
Baltimore, MD 21209-3746

Mailing address

2700 Quarry Lake Dr Ste 300
Baltimore, MD 21209-3746
Phone (410) 377-8900

Other names 1

  • Jennifer Rose Watkins Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210224000666 MD Practitioner - Physician Assistant 5799006250 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
017656NYMDSpeech-Language Pathologist
PA9106854FLMDPhysician Assistant
C07539MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Feb 1, 2021 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Feb 1, 2021 Accepting new patients
Centers for Advanced Orthopaedics, LLC Past Accepting new patients
Orthopaedic Associates of Central Maryland, PA Past Accepting new patients

Locations

2700 Quarry Lake Dr
Ste 300
Baltimore, MD 21209

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

1312 Bellona Ave
Ste 302
Lutherville Timonium, MD 21093
Phone (301) 637-8712

4 Park Center Ct
Ste 102
Owings Mills, MD 21117
Phone (410) 377-3484

4 Park Center Ct
Ste 200
Owings Mills, MD 21117

120 Westminster Pike
Ste 200
Reisterstown, MD 21136

Interoperability endpoints

  • Direct secure messaging: 38jtawil@cfaortho.emadirect.md

Organizations & group practices 5

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": "1352160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1093069460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 QUARRY LAKE DR STE 300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093746",
            "telephone_number": "410-377-8900",
            "fax_number": "410-377-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 QUARRY LAKE DR STE 300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093746",
            "telephone_number": "410-377-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAWIL",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-06",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017656",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106854",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C07539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WATKINS",
            "middle_name": "ROSE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.