Martinsburg Internal Medicine Assoc Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MARTINSBURG INTERNAL MEDICINE ASSOC INC

Practice address

1002 Sushruta Drive
Martinsburg, WV 25401

Phone

(304) 263-0913

Fax

(304) 267-2917

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jesse B Jalazo, MDNPI 1134181688

Title

President

Phone

(304) 263-0913

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Martinsburg Internal Medicine Lab Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jesse Brian Jalazo, MD

  • Internal Medicine Physician
  • Martinsburg, WV
  • NPI 1134181688
  NPD Authorized official

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689735565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 SUSHRUTA DRIVE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "25401",
            "telephone_number": "304-263-0913",
            "fax_number": "304-267-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 SUSHRUTA DRIVE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "25401",
            "telephone_number": "304-263-0913",
            "fax_number": "304-267-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTINSBURG INTERNAL MEDICINE ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JALAZO",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-263-0913",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008030001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Martinsburg Internal Medicine Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Martinsburg Center LLC
• Martinsburg Eye Associates PLLC
• Martinsburg Family Eye Care, PLLC
• Martinsburg Institute Inc
• Martinsburg Internal Medicine Assoc Inc
• Martinsburg Optical Inc
• Martinsburg Pediatrics
• Martinsburg Pharmacy LLC
• Martinsburg Radiology Assoc Inc
• Martinsburg SNF LLC

• Clinical Medical Laboratory in Martinsburg, WV
• Providers in Martinsburg, WV by specialty
• Clinical Medical Laboratory in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.