Individual provider Active NPI

David Kerwin Jacobs, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Lutherville, MD
National Provider Identifier
1093178386
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
D91262 Issued in MD
Practice address
1312 Bellona Ave Ste 302
Lutherville, MD 21093-5436
Phone
(410) 377-8900
NPI assigned
Apr 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X D91262 MD Primary
Physical Medicine & Rehabilitation Physician 208100000X D91262 MD

Addresses

Primary practice location

1312 Bellona Ave Ste 302
Lutherville, MD 21093-5436

Mailing address

1312 Bellona Ave Ste 302
Lutherville, MD 21093-5436
Phone (410) 377-8900

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
I20210602000840 MD Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 0042619611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians
Centers for Advanced Orthopaedics LLCGroup PAC ID 8123260981, 599 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

1312 Bellona Ave
Lutherville, MD 21093-5400
Phone (410) 377-8900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D91262MDMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jul 1, 2021 Accepting new patients
Centers for Advanced Orthopaedics, LLC Current Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jul 1, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Orthopaedic Associates of Central Maryland, PA Pain Medicine 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

Interoperability endpoints

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

Organizations & group practices 6

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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1093178386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 BELLONA AVE STE 302",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210935436",
            "telephone_number": "410-377-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 BELLONA AVE STE 302",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210935436",
            "telephone_number": "410-377-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "DAVID",
        "middle_name": "KERWIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MD",
            "license": "D91262",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "D91262",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

Verify at the official NPI Registry.