Theresa Donohue Jerussi, MS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0002298 Issued in MD

Practice address

10 Center Drive MSC 1202
Building 10, CRC RM 3-5272
Bethesda, MD 20892-0001

Phone

(301) 594-8003

Fax

(301) 480-0195

NPI assigned

Sep 10, 2008

Last updated

Apr 2, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Theresa B Donohue Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1558510909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CENTER DRIVE MSC 1202",
            "address_2": "BUILDING 10, CRC RM 3-5272",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208920001",
            "telephone_number": "301-594-8003",
            "fax_number": "301-480-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CENTER DRIVE MSC 1202",
            "address_2": "BUILDING 10, CRC RM 3-5272",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208920001",
            "telephone_number": "301-594-8003",
            "fax_number": "301-480-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERUSSI",
        "first_name": "THERESA",
        "middle_name": "DONOHUE",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "DONOHUE",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janet Jensen, P.T.
• Maxwell Jensen, MD
• Robert T Jensen, M.D.
• Valerie Ellen Jensen, R.PH.
• Elliott L Jermyn, PT
• Nele Jessel, MD
• Jessica Gottlieb LCPC, LLC
• Kimberly Ann Jessie, PH.D.
• Monica Andrea Jessup, DPM
• Jonathan P Jeter, M.D.

• Physician Assistant in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.