Active NPI
Jenita Ann Joe, MD
- Pediatrics Physician
- California, MD
National Provider Identifier
1639872740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- D0106373
- Practice address
- 22590 Shady Court
California, MD 20619-5009 - Phone
- (301) 373-7900
- Fax
- (301) 373-6900
- NPI assigned
- Mar 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | D0106373 | MD | Primary |
Addresses
Primary practice location
22590 Shady Court
California, MD 20619-5009
Mailing address
24035 Three Notch Rd
Hollywood, MD 20636-4871
Phone (301) 373-7900
Other practice location 1
1611 NW 12th Ave Ste 6006
Miami, FL 33136-1005
Phone (305) 585-4310
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 338564700 | Medicaid | MD |
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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Howard University College of Medicine, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
24035 Three Notch Rd
Hollywood, MD 20636-4871
PO Box
Suite 640
Hollywood, MD 20636
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787011200000",
"number": "1639872740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24035 THREE NOTCH RD",
"city": "HOLLYWOOD",
"state": "MD",
"postal_code": "206364871",
"telephone_number": "301-373-7900",
"fax_number": "301-373-6900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22590 SHADY COURT",
"city": "CALIFORNIA",
"state": "MD",
"postal_code": "206195009",
"telephone_number": "301-373-7900",
"fax_number": "301-373-6900"
}
],
"practiceLocations": [
{
"address_1": "1611 NW 12th Ave Ste 6006",
"address_purpose": "LOCATION",
"city": "Miami",
"state": "FL",
"postal_code": "331361005",
"country_code": "US",
"telephone_number": "305-585-4310",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOE",
"first_name": "JENITA",
"middle_name": "ANN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-27",
"last_updated": "2026-08-18",
"certification_date": "2026-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "D0106373",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "338564700",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in California, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.