Individual provider Active NPI

Jean Jeudy Jr., M.D.

  • Diagnostic Radiology Physician
  • Baltimore, MD
National Provider Identifier
1316971435
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D0061823 Issued in MD
Practice address
22 S Greene St, Dept of Radiology
Baltimore, MD 21201-1544
Phone
(410) 328-3477
NPI assigned
Jul 11, 2006
Last updated
Apr 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X D0061823 MD Primary

Addresses

Primary practice location

22 S Greene St, Dept of Radiology
Baltimore, MD 21201-1544

Mailing address

22 S Greene St, Dept of Radiology
Baltimore, MD 21201-1544
Phone (410) 328-3477

Other identifiers 2

IdentifierTypeStateIssuer
032200609MedicaidDC
405185800MedicaidMD

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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040902000956 MD Practitioner - Diagnostic Radiology 2961478847 Reassigns benefits to 5 organizations
I20181207001617 DC Practitioner - Diagnostic Radiology 2961478847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Maryland School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Imaging Network PCGroup PAC ID 6103259304, 79 clinicians
University Imaging Center, LLCGroup PAC ID 2769378686, 56 clinicians

Practice addresses (Care Compare)

10400 Odonnell PL
Suite 100
Waldorf, MD 20603-7290
Phone (410) 298-0454

130 Hospital Rd
Suite Ll100
Prince Frederick, MD 20678-4029
Phone (410) 535-4111

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-5700

22 Wainwright Ave
Annapolis, MD 21403-4509
Phone (443) 436-1100

401 Purdy St
Suite 104
Easton, MD 21601-4060
Phone (410) 298-0454

419 W Redwood St
Baltimore, MD 21201-1734
Phone (410) 328-3225

5 N la Plata CT
Suite 104
La Plata, MD 20646-5207
Phone (301) 539-0345

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0061823MDMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Imaging Services, LLC CurrentSince Dec 15, 2020 Accepting new patients
University of Maryland Diagnostic Radiology, LLC Diagnostic Radiology CurrentSince Jul 8, 2017 Accepting new patients
Maryland Imaging Network PC Diagnostic Radiology CurrentSince Jun 1, 2024 Accepting new patients
University of Maryland Diagnostic Radiology, LLC Diagnostic Radiology CurrentSince Jul 8, 2017 Accepting new patients
University Imaging Specialists Diagnostic Radiology Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

22 S Greene St
Rm N2E23
Baltimore, MD 21201
Phone (410) 328-5656

10715 Downsville Pike
Ste 103
Hagerstown, MD 21740
Phone (240) 313-9940

11110 Medical Campus Rd
Ste 245
Hagerstown, MD 21742
Phone (301) 714-4200

5 N La Plata Ct
Ste 104
La Plata, MD 20646
Phone (301) 539-0345

130 Hospital Rd
Ste LL100
Prnc Frederck, MD 20678
Phone (410) 535-4111

Interoperability endpoints

  • Direct secure messaging: jjeudy5071@direct.umm.edu

Organizations & group practices 7

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 7

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1316971435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST, DEPT OF RADIOLOGY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST, DEPT OF RADIOLOGY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEUDY",
        "first_name": "JEAN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0061823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032200609",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405185800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.