Individual provider Active NPI

Jayant L Patankar, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Frederick, MD
National Provider Identifier
1497756761
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
D0062376 Issued in MD
Practice address
400 W 7TH St
Pain and Supportive Services
Frederick, MD 21701-4506
Phone
(240) 566-3031
Fax
(240) 566-7400
NPI assigned
Aug 9, 2005
Last updated
Jul 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X D0062376 MD Primary

Addresses

Primary practice location

400 W 7TH St
Pain and Supportive Services
Frederick, MD 21701-4506

Mailing address

PO Box 37086
Baltimore, MD 21297-3086
Phone (240) 439-8913

Other identifiers 1

IdentifierTypeStateIssuer
0010904410009MedicaidPA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140305000588 MD Practitioner - Hospice/Palliative CarePractitioner - Family Practice 4486627171 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0062376MDMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Medical Group LLC CurrentSince Feb 3, 2014 Accepting new patients
Frederick Health Medical Group LLC Hospice and Palliative Medicine Current Accepting new patients
Frederick Health Medical Group LLC CurrentSince Feb 3, 2014 Accepting new patients
Elk Regional Health Center, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1 Frederick Health Way
Frederick, MD 21701
Phone (240) 439-8812

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

501 W 7th St
Frederick, MD 21701
Phone (301) 360-2574

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1497756761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37086",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973086",
            "telephone_number": "240-439-8913",
            "fax_number": "240-439-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 7TH ST",
            "address_2": "PAIN AND SUPPORTIVE SERVICES",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506",
            "telephone_number": "240-566-3031",
            "fax_number": "240-566-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATANKAR",
        "first_name": "JAYANT",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MD",
            "license": "D0062376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010904410009",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.