Individual provider Active NPI

Stephanie Adele Jacobs, MD

  • Obstetrics & Gynecology Physician
  • Baltimore, MD
National Provider Identifier
1699093666
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
D0081590 Issued in MD
Practice address
6569 North Charles Street
PPW 307
Baltimore, MD 21204
Phone
(443) 849-2767
Fax
(443) 849-8050
NPI assigned
May 14, 2010
Last updated
Feb 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X D0081590 MD Primary

Addresses

Primary practice location

6569 North Charles Street
PPW 307
Baltimore, MD 21204

Mailing address

6569 North Charles Street
PPW 307
Baltimore, MD 21204
Phone (443) 849-2767

Other identifiers 1

IdentifierTypeStateIssuer
109487400MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160719000955 MD Practitioner - Obstetrics/Gynecology 4082745005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Pittsburgh School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Greater Baltimore Medical CenterGroup PAC ID 1759276975, 350 clinicians

Practice addresses (Care Compare)

3701 N Charles St
South Chapman Building Suite 102
Towson, MD 21204-6808

63 E Padonia Rd
Timonium, MD 21093-2306

6565 N Charles St
Baltimore, MD 21204-6808

6569 N Charles St
Baltimore, MD 21204-5816

6569 N Charles St
Suite 505
Baltimore, MD 21204-6808
Phone (443) 849-2658

6569 N Charles St PPW Room
307 GYN Specialists
Baltimore, MD 21204-6808
Phone (443) 849-6123

6569 N Charles Street
504 Hoover Low Vision GBMC
Baltimore, MD 21204-6808
Phone (443) 849-2658

6701 N Charles St
Baltamore, MD 21204-6808

6701 N Charles St BLDG
S Chapman BLDG Suite 102
Baltimore, MD 21204-6808

6701 N Charles St Unit
Baltimore, MD 21204-6808
Phone (443) 849-3131

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
111035CAMDGeneral Practice Dentistry
D0081590MDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Baltimore Medical Center, Inc. CurrentSince Jun 20, 2016 Accepting new patients
Greater Baltimore Medical Center, Inc. CurrentSince Jun 20, 2016 Accepting new patients
Greater Baltimore Medical Center, Inc Obstetrics & Gynecology Current Accepting new patients
Greater Baltimore Medical Center, Inc. Past Accepting new patients

Locations

6569 N Charles St
Ste 307
Towson, MD 21204
Phone (443) 849-2767

6569 N Charles St
Ste 505
Towson, MD 21204
Phone (443) 849-2196

Interoperability endpoints

  • Direct secure messaging: sjacobs18863@gbmcdirect.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1699093666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6569 NORTH CHARLES STREET",
            "address_2": "PPW 307",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21204",
            "telephone_number": "443-849-2767",
            "fax_number": "443-849-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6569 NORTH CHARLES STREET",
            "address_2": "PPW 307",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21204",
            "telephone_number": "443-849-2767",
            "fax_number": "443-849-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "STEPHANIE",
        "middle_name": "ADELE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-14",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D0081590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109487400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.