NPIMap

Organization Active NPI

Jewish Social Service Agency

  • Community/Behavioral Health Agency
  • Rockville, MD
National Provider Identifier
1629470513
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
JEWISH SOCIAL SERVICE AGENCY
Practice address
6123 Montrose Rd
Rockville, MD 20852-4860
Phone
(301) 881-3700
NPI assigned
Sep 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Authorized official

Name
Tal B Widdes
Title
Chief Operating Officer
Phone
(301) 881-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

6123 Montrose Rd
Rockville, MD 20852-4860

Mailing address

6123 Montrose Rd
Rockville, MD 20852-4860
Phone (301) 881-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121001177 DC Part B Supplier - Clinic/Group Practice 8123920097 Receives reassigned benefits from 37 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fairfax, VA; Rockville, MD

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Jewish Social Service Agency15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

200 Wood Hill Rd
Rockville, MD 20850
Phone (240) 800-5772

Practitioners & affiliated clinicians

Practitioners 7

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": "1411430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411430400000",
    "number": "1629470513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6123 MONTROSE RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524860",
            "telephone_number": "301-881-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6123 MONTROSE RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524860",
            "telephone_number": "301-881-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWISH SOCIAL SERVICE AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A",
        "authorized_official_last_name": "WIDDES",
        "authorized_official_first_name": "TAL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "301-881-3700"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.