NPIMap

Organization Active NPI

Annapolis Rheumatology LLC

  • Rheumatology Physician
  • Annapolis, MD
National Provider Identifier
1104188424
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
ANNAPOLIS RHEUMATOLOGY LLC
Practice address
166 Defense Hwy Ste 200
Annapolis, MD 21401-8922
Phone
(410) 897-1941
NPI assigned
Jun 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Authorized official

Name
Ashok Jacob, M.D.NPI 1467676759
Title
Manging Director
Phone
(301) 367-3235

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X Primary
Non-Pharmacy Dispensing Site 332900000X

Addresses

Primary practice location

166 Defense Hwy Ste 200
Annapolis, MD 21401-8922

Mailing address

166 Defense Hwy Ste 200
Annapolis, MD 21401-8922
Phone (410) 897-1941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120911000659 MD Part B Supplier - Clinic/Group Practice 8123276425 Receives reassigned benefits from 15 practitioners
Practice locations: Clarksville, MD; Towson, MD; Pasadena, MD; Owings Mills, MD; Bel Air, MD; Annapolis, MD
O20200605000816 DC Part B Supplier - Clinic/Group Practice 8123276425 Receives reassigned benefits from 6 practitioners
Practice locations: Alexandria, VA; Fairfax, VA; Rockville, MD

National Provider Directory

National Provider Directory
Tax ID family
Annapolis Rheumatology LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

510 Upper Chesapeake Dr
Ste 413
Bel Air, MD 21014

510 Upper Chesapeake Dr
Ste 41
Bel Air, MD 21014

1600 N Beauregard St
Ste 105
Alexandria, VA 22311

4660 Kenmore Ave
Ste 514
Alexandria, VA 22304
Phone (703) 461-3452

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFAJBA

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1104188424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 DEFENSE HWY STE 200",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214018922",
            "telephone_number": "410-897-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 DEFENSE HWY STE 200",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214018922",
            "telephone_number": "410-897-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNAPOLIS RHEUMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-12",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "ASHOK",
        "authorized_official_title_or_position": "MANGING DIRECTOR",
        "authorized_official_telephone_number": "301-367-3235",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.