NPIMap

Individual provider Active NPI

Jonathan Scott Fish, MD

  • Internal Medicine Physician
  • Marriottsville, MD
National Provider Identifier
1497748883
Registry record updated Nov 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0051860 Issued in MD
Practice address
2470 Longstone LN Ste I
Marriottsville, MD 21104-1523
Phone
(410) 910-2300
Fax
(410) 740-9134
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0051860 MD Primary

Addresses

Primary practice location

2470 Longstone LN Ste I
Marriottsville, MD 21104-1523

Mailing address

2470 Longstone LN
Ste I
Marriottsville, MD 21104-1523
Phone (410) 910-2300

Other identifiers 2

IdentifierTypeStateIssuer
B6100004OtherDCBC BS
769210200MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101209000804 MD Practitioner - Internal Medicine 8527255017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Charter Internal Medicine, LLCGroup PAC ID 0244204113, 2 clinicians

Practice addresses (Care Compare)

2470 Longstone LN
Suite I
Marriottsville, MD 21104-1523
Phone (410) 910-2300

Hospital & facility affiliations

  • Bayada Home Health Care, Inc. Home health agency, Towson, MD, CCN 217101
  • The Johns Hopkins Home Health Services, Inc Home health agency, Baltimore, MD, CCN 217081

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charter Internal Medicine, LLC Internal Medicine CurrentSince Jan 1, 1997 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2470 Longstone Ln
Ste I
Marriottsvl, MD 21104
Phone (410) 910-2300

Interoperability endpoints

  • Direct secure messaging: jonathan.fish.1@23291.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23291/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Johns Hopkins Howard County Medical CenterColumbia, MD, CCN 210048 Hospital Corporate Director Jul 1, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510617600000",
    "number": "1497748883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2470 LONGSTONE LN",
            "address_2": "STE I",
            "city": "MARRIOTTSVILLE",
            "state": "MD",
            "postal_code": "211041523",
            "telephone_number": "410-910-2300",
            "fax_number": "410-910-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 LONGSTONE LN STE I",
            "city": "MARRIOTTSVILLE",
            "state": "MD",
            "postal_code": "211041523",
            "telephone_number": "410-910-2300",
            "fax_number": "410-740-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "JONATHAN",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0051860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "B6100004",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "769210200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marriottsville, MD

Sources for this page

Verify at the official NPI Registry.