NPIMap

Organization Active NPI

Jen-John Inc

Doing business as DSF Cosmetic and Medical Dermatology

  • Dermatology Physician
  • Frederick, MD
National Provider Identifier
1114039377
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
D0040701 Issued in MD
Legal business name
JEN-JOHN INC
Doing business as
DSF Cosmetic and Medical Dermatology
Practice address
68 Thomas Johnson Dr Ste C
Frederick, MD 21702-4901
Phone
(301) 694-5292
Fax
(866) 469-9533
NPI assigned
Aug 31, 2006
Last updated
Aug 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Authorized official

Name
Monica McRae
Title
Assistant Office Manager
Phone
(301) 694-5292

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X D0040701 MD Primary

Addresses

Primary practice location

68 Thomas Johnson Dr Ste C
Frederick, MD 21702-4901

Mailing address

PO Box 1924
Frederick, MD 21702
Phone (301) 694-5292

Other names 1

  • DSF Cosmetic and Medical Dermatology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051012000802 MD Part B Supplier - Clinic/Group Practice 3870518434 Receives reassigned benefits from 6 practitioners
Practice locations: Frederick, MD

National Provider Directory

National Provider Directory

Locations

68 Thomas Johnson Dr
Ste C
Frederick, MD 21702
Phone (301) 594-5292

Practitioners & affiliated clinicians

Practitioners 8

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754438400000",
    "number": "1114039377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1924",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21702",
            "telephone_number": "301-694-5292",
            "fax_number": "866-469-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 THOMAS JOHNSON DR STE C",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024901",
            "telephone_number": "301-694-5292",
            "fax_number": "866-469-9533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEN-JOHN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A",
        "authorized_official_last_name": "MCRAE",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "ASSISTANT OFFICE MANAGER",
        "authorized_official_telephone_number": "301-694-5292"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0040701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DSF Cosmetic and Medical Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.