Organization Active NPI

Jay S Lebow DPM PA

  • Sports Medicine Podiatrist
  • Baltimore, MD
National Provider Identifier
1609808443
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine PodiatristTaxonomy code 213ES0000X
Legal business name
JAY S LEBOW DPM PA
Practice address
1626 E Fort Ave
Baltimore, MD 21230-5245
Phone
(410) 332-1414
Fax
(410) 332-1423
NPI assigned
Jul 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Authorized official

Name
Dr. Jay S. Lebow, DPM
Title
President
Phone
(410) 332-1414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0000X Primary

Addresses

Primary practice location

1626 E Fort Ave
Baltimore, MD 21230-5245

Mailing address

1626 E Fort Ave
Baltimore, MD 21230-5245
Phone (410) 332-1414

Other identifiers 2

IdentifierTypeStateIssuer
480002770OtherMDMEDICARE RAILROAD
548128700MedicaidMD

Other names 1

  • LEBOW PODIATRY Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1609808443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 E FORT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212305245",
            "telephone_number": "410-332-1414",
            "fax_number": "410-332-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 E FORT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212305245",
            "telephone_number": "410-332-1414",
            "fax_number": "410-332-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY S LEBOW DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "LEBOW",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-332-1414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "480002770",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "548128700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LEBOW PODIATRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.