Individual provider Active NPI

Jennifer Lynn Gularson, P.A.-C

  • Physician Assistant
  • Rockville, MD
National Provider Identifier
1548266752
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0002222 Issued in MD
Practice address
3200 Tower Oaks Blvd Ste 430
Rockville, MD 20852-4276
Phone
(301) 231-5050
Fax
(877) 781-0056
NPI assigned
Jun 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0002222 MD Primary

Addresses

Primary practice location

3200 Tower Oaks Blvd Ste 430
Rockville, MD 20852-4276

Mailing address

3200 Tower Oaks Blvd Ste 430
Rockville, MD 20852-4276
Phone (301) 231-5050

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
I20221007001746 MD Order and Referring Only - Physician Assistant 1658474051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0002222MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Secure Medical Associates, LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1548266752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 TOWER OAKS BLVD STE 430",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524276",
            "telephone_number": "301-231-5050",
            "fax_number": "777-810-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 TOWER OAKS BLVD STE 430",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524276",
            "telephone_number": "301-231-5050",
            "fax_number": "877-781-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULARSON",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.