Individual provider Active NPI

Jillienne Rose Caw, PA-C

  • Physician Assistant
  • Frederick, MD
National Provider Identifier
1205317328
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0006892 Issued in MD
Practice address
196 Thomas Johnson Dr Ste 120
Frederick, MD 21702-4521
Phone
(240) 566-3130
Fax
(240) 566-3131
NPI assigned
Aug 27, 2018
Last updated
May 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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 C0006892 MD Primary

Addresses

Primary practice location

196 Thomas Johnson Dr Ste 120
Frederick, MD 21702-4521

Mailing address

196 Thomas Johnson Dr Ste 120
Frederick, MD 21702-4521
Phone (240) 566-3130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20181105000048 MD Practitioner - Physician Assistant 1254684541 Reassigns benefits to 2 organizations
I20200526000168 DC Practitioner - Physician Assistant 1254684541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

196 Thomas Johnson Dr
Suite 120
Frederick, MD 21702-4521
Phone (240) 566-3130

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 566-3300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0006892MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Neurology Services, P.a. CurrentSince May 18, 2020 Accepting new patients
Comprehensive Neurology Services, P.a. CurrentSince May 18, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

196 Thomas Johnson Dr
Ste 120
Frederick, MD 21702
Phone (240) 566-3130

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

19801 Observation Dr
Germantown, MD 20876
Phone (301) 557-5928

Interoperability endpoints

  • Direct secure messaging: jillienne.caw@cnsp.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1205317328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 THOMAS JOHNSON DR STE 120",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024521",
            "telephone_number": "240-566-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 THOMAS JOHNSON DR STE 120",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024521",
            "telephone_number": "240-566-3130",
            "fax_number": "240-566-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAW",
        "first_name": "JILLIENNE",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0006892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.