NPIMap

Organization Active NPI

Jewish Social Service Agency

  • Community Based Hospice Care Agency
  • Rockville, MD
National Provider Identifier
1154512440
Registry record updated Sep 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
JEWISH SOCIAL SERVICE AGENCY
Practice address
6123 Montrose Rd
Rockville, MD 20852-4860
Phone
(301) 816-2616
Fax
(301) 468-1862
NPI assigned
Aug 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2007

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

Authorized official

Name
Mr. Robert Johnson
Title
Chief Financial Officer
Phone
(301) 816-2602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

6123 Montrose Rd
Rockville, MD 20852-4860

Mailing address

6123 Montrose Rd
Rockville, MD 20852-4860
Phone (301) 816-2616

Other identifiers 1

IdentifierTypeStateIssuer
553241800MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121001177 DC Part B Supplier - Clinic/Group Practice 8123920097 Receives reassigned benefits from 37 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fairfax, VA; Rockville, MD

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Jewish Social Service Agency15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190592000000",
    "number": "1154512440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6123 MONTROSE RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524860",
            "telephone_number": "301-816-2616",
            "fax_number": "301-468-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6123 MONTROSE RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524860",
            "telephone_number": "301-816-2616",
            "fax_number": "301-468-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWISH SOCIAL SERVICE AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-09-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "301-816-2602",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "553241800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; 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.