Primecare Pediatrics

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

D31052 Issued in MD

Legal business name

PRIMECARE PEDIATRICS

Doing business as

Dr Jay Gopal MD

Practice address

5820 York Rd
Ste 23
Baltimore, MD 21212-3610

Phone

(410) 532-2147

Fax

(410) 323-9376

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Jay Gopal

Title

Owner

Phone

(410) 532-2147

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DR JAY GOPAL MD Doing business as

Tax ID family

Dr Jay Gopal MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Primecare Pediatrics

  dba Jay J Gopal MD

  • Pediatric Adolescent Medicine Physician
  • Baltimore, MD
  • NPI 1285757971
  NPD tax ID

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326117276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 YORK RD",
            "address_2": "STE 23",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212123610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 YORK RD",
            "address_2": "STE 23",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212123610",
            "telephone_number": "410-532-2147",
            "fax_number": "410-323-9376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOPAL",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-532-2147"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "MD",
            "license": "D31052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2133154",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DR JAY GOPAL MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Prime Care Transformation Organization, LLC (Prime CTO)
• Prime Clinical Associates, LLC (Prime Clinical Associates)
• Prime Health Care Agency Inc
• Prime Medical Supply Co., Inc.
• Primecare Pediatrics (Jay J Gopal MD)
• Primehealth Behavioral Healthcare Services LLC
• Primemed LLC
• Annelle B Primm, M.D.
• Prince of Peace Healthcare Services Inc
• Prince of Peace, Inc

• Non-Pharmacy Dispensing Site in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Non-Pharmacy Dispensing Site in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.