Individual provider Active NPI

Jeffrey Mark Peaper, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1134478415
Registry record updated Sep 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0004830 Issued in MD
Practice address
1419 Knecht Ave
Baltimore, MD 21227-1415
Phone
(410) 247-9595
Fax
(410) 247-7553
NPI assigned
Sep 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0004830 MD Primary

Addresses

Primary practice location

1419 Knecht Ave
Baltimore, MD 21227-1415

Mailing address

1419 Knecht Ave
Baltimore, MD 21227-1415
Phone (410) 247-9595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121213000398 DC Practitioner - Physician Assistant 6002068319 Reassigns benefits to 1 organization
I20121214000274 MD Practitioner - Physician Assistant 6002068319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

1419 Knecht Ave
Baltimore, MD 21227-1415
Phone (410) 247-9595

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0004830MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care, PA. CurrentSince Sep 24, 2012 Accepting new patients
American Current Care PA CurrentSince Sep 24, 2012 Accepting new patients
American Current Care P.a. CurrentSince Sep 24, 2012 Accepting new patients

Locations

1419 Knecht Ave
Halethorpe, MD 21227
Phone (410) 247-9595

4451 Parliament Pl
Ste G
Lanham, MD 20706
Phone (301) 459-9113

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 4

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": "1346630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346630400000",
    "number": "1134478415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 KNECHT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212271415",
            "telephone_number": "410-247-9595",
            "fax_number": "410-247-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 KNECHT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212271415",
            "telephone_number": "410-247-9595",
            "fax_number": "410-247-7553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAPER",
        "first_name": "JEFFREY",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-03",
        "last_updated": "2012-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0004830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.