Individual provider Active NPI

Jinkle Mody

  • Gerontology Nurse Practitioner
  • Germantown, MD
National Provider Identifier
1255154670
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R237791 Issued in MD
Practice address
12800 Middlebrook Rd Ste 400
Germantown, MD 20874-5282
Phone
(301) 284-3181
NPI assigned
Nov 4, 2024
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R237791 MD Primary

Addresses

Primary practice location

12800 Middlebrook Rd Ste 400
Germantown, MD 20874-5282

Mailing address

12800 Middlebrook Rd Ste 400
Germantown, MD 20874-5282

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
I20250108001065 MD Practitioner - Nurse Practitioner 3779011523 Reassigns benefits to 1 organization
I20250108001186 DC Practitioner - Nurse Practitioner 3779011523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors First, LLCGroup PAC ID 3870661978, 58 clinicians

Practice addresses (Care Compare)

12800 Middlebrook Rd
Suite 400
Germantown, MD 20874-5282
Phone (301) 515-2901

196 Thomas Johnson Dr
Suite 235
Frederick, MD 21702-4525
Phone (301) 515-2901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors First, LLC CurrentSince Nov 4, 2024 Accepting new patients
Doctors First, LLC CurrentSince Nov 4, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

196 Thomas Johnson Dr
Ste 235
Frederick, MD 21702
Phone (301) 668-7700

806 W Diamond Ave
Ste 110
Gaithersburg, MD 20878
Phone (240) 342-2407

12800 Middlebrook Rd
Ste 400
Germantown, MD 20874
Phone (240) 217-7794

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1255154670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 MIDDLEBROOK RD STE 400",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208745282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 MIDDLEBROOK RD STE 400",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208745282",
            "telephone_number": "301-284-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODY",
        "first_name": "JINKLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R237791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

Verify at the official NPI Registry.