Sally Dale G Jafari, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R069947 Issued in MD

Practice address

403 Purdy St
Suite 203
Easton, MD 21601-4059

Phone

(410) 822-7040

Fax

(410) 822-7056

NPI assigned

Sep 12, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dale G Reddish Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Maryland Community Medical Group IncGroup PAC ID 3678472214, 446 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.26 of 100Reported as group

Quality

81.56

Promoting interoperability

100

Improvement activities

40

Cost

69.29

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjafari85640@direct.umm.edu

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.

• University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1477530624
  Medicare reassignment Care Compare group NPD
• University of Maryland Community Medical Group, Inc.

  • Psychiatry Physician
  • La Plata, MD
  • NPI 1679393854
  NPD

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1174517668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 PURDY ST",
            "address_2": "SUITE 203",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216014059",
            "telephone_number": "410-822-7040",
            "fax_number": "410-822-7056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 PURDY ST",
            "address_2": "SUITE 203",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216014059",
            "telephone_number": "410-822-7040",
            "fax_number": "410-822-7056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFARI",
        "first_name": "SALLY DALE",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R069947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130003200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287111400",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000969542",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DALE",
            "last_name": "REDDISH",
            "middle_name": "G",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Diane Irven, CAC-AD
• J Fredrick Heaton DMD PA
• Daphime Jackson, CSC-AD
• Lateshia Jackson
• Mia Jackson, LGPC
• James & Dyer, M.D.,P.a.
• James P Thompson MD PA (Midshore Surgical Eye Center)
• James P Thompson MD PA
• Alden James, M.D.
• Angela Jancosko

• Family Nurse Practitioner in Easton, MD
• Providers in Easton, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.