Individual provider Active NPI

Michael Cory Jecmen, M.AC., L.AC.

  • Acupuncturist
  • Bethesda, MD
National Provider Identifier
1619110756
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
UO1732 Issued in MD
Practice address
4701 Sangamore Rd
Bethesda, MD 20816-2508
Phone
(240) 507-5110
Fax
(844) 682-8102
NPI assigned
Apr 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X UO1732 MD Primary

Addresses

Primary practice location

4701 Sangamore Rd
Bethesda, MD 20816-2508

Mailing address

41869 Dublane PL
Ashburn, VA 20148-8038
Phone (240) 498-9979

Other practice location 1

4933 Auburn Ave
207 C
Bethesda, MD 20814-2631
Phone (240) 498-9979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
UO1732MDMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Acupuncture, LLC Acupuncturist Past Accepting new patients
Happy Health and Wellness East LLC PastSince May 26, 2024 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": "1239926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1619110756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41869 DUBLANE PL",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201488038",
            "telephone_number": "240-498-9979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 SANGAMORE RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208162508",
            "telephone_number": "240-507-5110",
            "fax_number": "844-682-8102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4933 Auburn Ave",
            "address_2": "207 C",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208142631",
            "country_code": "US",
            "telephone_number": "240-498-9979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JECMEN",
        "first_name": "MICHAEL",
        "middle_name": "CORY",
        "name_prefix": "Mr.",
        "credential": "M.AC., L.AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "UO1732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.