Individual provider Active NPI

Jerry Isadore Levine, M.D.

  • Internal Medicine Physician
  • Columbia, MD
National Provider Identifier
1295736429
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0022856 Issued in MD
Practice address
5900 Waterloo Rd Ste 200
Columbia, MD 21045-2641
Phone
(410) 740-2900
Fax
(410) 992-0732
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0022856 MD Primary

Addresses

Primary practice location

5900 Waterloo Rd Ste 200
Columbia, MD 21045-2641

Mailing address

7580 Buckingham Blvd Ste 20
Hanover, MD 21076-3208
Phone (410) 729-5100

Other identifiers 11

IdentifierTypeStateIssuer
1865815OtherMDCIGNA PIN
4238661OtherMDAETNA FEE FOR SERVICE
3509-0004OtherMDCAREFIRST BLUECHOICE
843368OtherMDMAMSI PRIMARY CARE
243368OtherMDMAMSI SPECIALIST
020550OtherMDJHHC PROVIDER NUMBER
P12725OtherMDCAREFIRST MPOS
110142478OtherMDRR MEDICARE
0477651OtherMDAETNA CAPITATED
366910-01OtherMDCAREFIRST MD RENDERING
780581100MedicaidMD

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100701000571 MD Practitioner - Internal Medicine 5092846246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York Medical College, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maryland Primary Care Physicians, LLCGroup PAC ID 8729981832, 101 clinicians

Practice addresses (Care Compare)

5900 Waterloo Rd
Suite 200
Columbia, MD 21045-2641
Phone (410) 740-2900

Hospital & facility affiliations

  • Bayada Home Health Care, Inc. Home health agency, Towson, MD, CCN 217101
  • Centerwell Home Health Home health agency, Columbia, MD, CCN 217071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Primary Care Physicians, LLC CurrentSince Feb 1, 1997 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1509 Ritchie Hwy
Arnold, MD 21012
Phone (410) 757-1600

11055 Little Patuxent Pkwy
Ste 104
Columbia, MD 21044
Phone (410) 740-0770

5900 Waterloo Rd
Ste 200
Columbia, MD 21045
Phone (410) 321-8452

1111 Benfield Blvd
Ste 200
Millersville, MD 21108
Phone (410) 729-5100

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1295736429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 BUCKINGHAM BLVD STE 20",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210763208",
            "telephone_number": "410-729-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 WATERLOO RD STE 200",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452641",
            "telephone_number": "410-740-2900",
            "fax_number": "410-992-0732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "JERRY",
        "middle_name": "ISADORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0022856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "1865815",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA FEE FOR SERVICE",
            "identifier": "4238661",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECHOICE",
            "identifier": "3509-0004",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI PRIMARY CARE",
            "identifier": "843368",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI SPECIALIST",
            "identifier": "243368",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JHHC PROVIDER NUMBER",
            "identifier": "020550",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MPOS",
            "identifier": "P12725",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110142478",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CAPITATED",
            "identifier": "0477651",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD RENDERING",
            "identifier": "366910-01",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "780581100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.