Jassi Primary Care PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JASSI PRIMARY CARE PA

Practice address

325 Hospital Dr Ste 205
Glen Burnie, MD 21061-5807

Phone

(443) 410-3161

Fax

(443) 410-3199

NPI assigned

Jan 16, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Kiran Jassi

Title

Office Manager

Phone

(443) 410-3161

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JADEBD

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sukhpal I Jassi, M.D

  • Internal Medicine Physician
  • Glen Burnie, MD
  • NPI 1649205238
  Medicare reassignment NPD

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1306310073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 HOSPITAL DR STE 205",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615807",
            "telephone_number": "443-410-3161",
            "fax_number": "443-410-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 HOSPITAL DR STE 205",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615807",
            "telephone_number": "443-410-3161",
            "fax_number": "443-410-3199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 Hospital Dr Ste 205",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "21061",
            "country_code": "US",
            "telephone_number": "443-410-3161",
            "fax_number": "443-410-3199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7625 Maple Lawn Blvd Ste 145",
            "address_purpose": "LOCATION",
            "city": "Fulton",
            "state": "MD",
            "postal_code": "207592565",
            "country_code": "US",
            "telephone_number": "443-410-3161",
            "fax_number": "443-410-3199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JASSI PRIMARY CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-16",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A",
        "authorized_official_last_name": "JASSI",
        "authorized_official_first_name": "KIRAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "443-410-3161",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68100400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica James
• Sukhan Jamshaid
• Christine Ann Janson, R.N.
• Julie Jarrell Sharma
• Gwynneth L Jarrell
• Sukhpal I Jassi, M.D
• Madhu Sreekanth Jasti, M.D
• Elnaz Javadkhani, DDS
• Thirumalairaj Jeevan, M.D.
• Jeffrey L Bober DPM PA

• Internal Medicine Physician in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.