Individual provider Active NPI

Jocelyn Niemkiewicz, PA-C

  • Medical Physician Assistant
  • Westminster, MD
National Provider Identifier
1487038865
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0005835 Issued in MD
Practice address
295 Stoner Ave Ste 204
Westminster, MD 21157-5637
Phone
(410) 876-8332
NPI assigned
Jul 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0005835 MD Primary

Addresses

Primary practice location

295 Stoner Ave Ste 204
Westminster, MD 21157-5637

Mailing address

5601 Loch Raven Blvd
Baltimore, MD 21239-2945

Other practice location 1

5601 Loch Raven Blvd
Baltimore, MD 21239-2945
Phone (443) 444-8000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151022002353 MD Practitioner - Physician Assistant 6002125549 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0005835MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pikesville MD Endoscopy ASC LLC Current Accepting new patients
Carroll Health Group, LLC CurrentSince May 1, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Dr Wendy Kloesz, M.D., P.a Past Accepting new patients

Locations

1838 Greene Tree Rd
Ste 180
Pikesville, MD 21208
Phone (410) 358-1800

193 Stoner Ave
Ste 220
Westminster, MD 21157
Phone (410) 871-2204

295 Stoner Ave
Ste 204
Westminster, MD 21157
Phone (410) 876-8332

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1487038865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 STONER AVE STE 204",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575637",
            "telephone_number": "410-876-8332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5601 Loch Raven Blvd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212392945",
            "country_code": "US",
            "telephone_number": "443-444-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEMKIEWICZ",
        "first_name": "JOCELYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0005835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

Verify at the official NPI Registry.