Individual provider Active NPI

Judah Minkove, M.D.

  • Internal Medicine Physician
  • Reisterstown, MD
National Provider Identifier
1649238841
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D27123 Issued in MD
Practice address
750 Main St Ste 205
Reisterstown, MD 21136-2516
Phone
(410) 526-3042
Fax
(410) 584-1889
NPI assigned
May 4, 2006
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D27123 MD Primary

Addresses

Primary practice location

750 Main St Ste 205
Reisterstown, MD 21136-2516

Mailing address

515 Fairmount Ave Ste 400
Towson, MD 21286-8518
Phone (410) 526-3042

Other identifiers 1

IdentifierTypeStateIssuer
32921100MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address judah.minkove.p2@direct.clinicalassociates.nextgenshare.com

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Clinical Associates P a Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: judah.minkove.p2@direct.clinicalassociates.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1649238841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 FAIRMOUNT AVE STE 400",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212868518",
            "telephone_number": "410-526-3042",
            "fax_number": "410-584-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MAIN ST STE 205",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211362516",
            "telephone_number": "410-526-3042",
            "fax_number": "410-584-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINKOVE",
        "first_name": "JUDAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D27123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32921100",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "judah.minkove.p2@direct.clinicalassociates.nextgenshare.com",
            "affiliation": "N",
            "address_1": "750 Main St Ste 205",
            "city": "Reisterstown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211362516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Reisterstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.