Individual provider Active NPI

John Scott Givler Jr., PA-C

  • Medical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1629386222
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0004325 Issued in MD
Practice address
17 Fontana LN Ste 101
Baltimore, MD 21237-3017
Phone
(410) 687-0000
Fax
(410) 391-8656
NPI assigned
Sep 16, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0004325 MD
Medical Physician Assistant 363AM0700X C0004325 MD Primary

Addresses

Primary practice location

17 Fontana LN Ste 101
Baltimore, MD 21237-3017

Mailing address

17 Fontana LN 101
Baltimore, MD 21237-3017
Phone (410) 687-0000

Medicare participation

Medicare enrollment files
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C0004325MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hassan Kassamali, MD PA PastSince Sep 30, 1996 Accepting new patients

Organizations & group practices 1

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": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1629386222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 FONTANA LN 101",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373017",
            "telephone_number": "410-687-0000",
            "fax_number": "410-391-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 FONTANA LN STE 101",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373017",
            "telephone_number": "410-687-0000",
            "fax_number": "410-391-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIVLER",
        "first_name": "JOHN",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-16",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0004325",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0004325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.