Organization Active NPI

Allan D. Jensen M.D., P.a.

  • Ophthalmology Physician
  • Baltimore, MD
National Provider Identifier
1174826671
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
ALLAN D. JENSEN M.D., P.A.
Practice address
200 E 33Rd St
Suite 426
Baltimore, MD 21218-3322
Phone
(410) 235-1133
NPI assigned
Dec 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2010

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

Authorized official

Name
Allan D Jensen, M.D.NPI 1326023326
Title
President
Phone
(410) 235-1133

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

200 E 33Rd St
Suite 426
Baltimore, MD 21218-3322

Mailing address

200 E 33Rd St
Suite 426
Baltimore, MD 21218-3322
Phone (410) 235-1133

Other identifiers 2

IdentifierTypeStateIssuer
4573ADOtherMDMEDICARE
006271500MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101216000857 MD Part B Supplier - Clinic/Group Practice 8426246406 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Locations

86 State Cir
Annapolis, MD 21401
Phone (410) 263-3492

200 E 33rd St
Ste 426
Baltimore, MD 21218
Phone (301) 235-1133

Practitioners & affiliated clinicians

Practitioners 1

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": "1291593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291593600000",
    "number": "1174826671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 33RD ST",
            "address_2": "SUITE 426",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183322",
            "telephone_number": "410-235-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 33RD ST",
            "address_2": "SUITE 426",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183322",
            "telephone_number": "410-235-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLAN D. JENSEN M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-06",
        "last_updated": "2010-12-06",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-235-1133",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "4573AD",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006271500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.