NPIMap

Organization Active NPI

Park Heights Medical Clinic LLC

Doing business as Jai Medical Center

  • Family Medicine Physician
  • Baltimore, MD
National Provider Identifier
1639101462
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PARK HEIGHTS MEDICAL CLINIC LLC
Doing business as
Jai Medical Center
Jai Medical Center/ Park Heights
Practice address
4340 Park Heights Ave
Baltimore, MD 21215-6725
Phone
(410) 542-8130
Fax
(410) 542-1826
NPI assigned
Jul 6, 2006
Last updated
May 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Authorized official

Name
Jai M Seunarine
Title
Ceo
Phone
(410) 433-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

4340 Park Heights Ave
Baltimore, MD 21215-6725

Mailing address

5010 York Rd
Baltimore, MD 21212-4437
Phone (410) 433-2200

Other identifiers 3

IdentifierTypeStateIssuer
K614PAOtherMDBLUECROSS/BLUESHEILD MD
069231000MedicaidMD
1347OtherMDJAI MEDICAL SYSTEM MCO

Other names 2

  • JAI MEDICAL CENTER Doing business as
  • JAI MEDICAL CENTER/ PARK HEIGHTS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070410000531 MD Part B Supplier - Clinic/Group Practice 7012012651 Receives reassigned benefits from 22 practitioners
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Locations

5010 York Rd
Baltimore, MD 21212
Phone (410) 433-2200

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

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": "1746403200000",
    "number": "1639101462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 YORK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212124437",
            "telephone_number": "410-433-2200",
            "fax_number": "410-532-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 PARK HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212156725",
            "telephone_number": "410-542-8130",
            "fax_number": "410-542-1826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK HEIGHTS MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A",
        "authorized_official_last_name": "SEUNARINE",
        "authorized_official_first_name": "JAI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-433-2200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHEILD MD",
            "identifier": "K614PA",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069231000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JAI MEDICAL SYSTEM MCO",
            "identifier": "1347",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JAI MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JAI MEDICAL CENTER/ PARK HEIGHTS",
            "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 May 5, 2025; 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.