Jeffery Jawni Dormu, D.O.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

D0034245 Issued in DC

Practice address

8730 Cherry Lane
Suite 10
Laurel, MD 20707

Phone

(301) 497-1590

Fax

(240) 334-4781

NPI assigned

Oct 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

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

Specialty

Vascular SurgeryAlso: General Surgery

Education

New York College of Osteo Medicine of New York Institute of Technology, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Vitalize Medical Vascular and Wellness Center LLC

  • Internal Medicine Physician
  • Laurel, MD
  • NPI 1366202764

  MD

  Medicare reassignment NPD
• Mivc ASC, LLC

  • Ambulatory Surgical Clinic/Center
  • Laurel, MD
  • NPI 1174074538
  NPD Authorized official
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515

  Surgery

  NPD (past)

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1366430316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8730 CHERRY LANE",
            "address_2": "SUITE 10",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "301-497-1590",
            "fax_number": "240-334-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8730 CHERRY LANE",
            "address_2": "SUITE 10",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "301-497-1590",
            "fax_number": "240-334-4781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMU",
        "first_name": "JEFFERY",
        "middle_name": "JAWNI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MB07611900",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "H0065639",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "DC",
            "license": "DO034245",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MD",
            "license": "H0065639",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "DC",
            "license": "D0034245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031107300",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0048615",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054737700",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kofi Dofour
• Fidelis Feh Doh, MD
• Milford Doherty
• Adalia Joanne Dominique
• Yoldy Dorisca
• Tasha Dorsey, PSY.D
• Mahmoud H Doski, M.D.
• Thelma Dovi Atopley
• Iyana Downie
• Shanelle D Downing

• All providers in Laurel, MD
• Vascular Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.