NPIMap

Individual provider Active NPI

Jennifer Y So, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Baltimore, MD
National Provider Identifier
1700149440
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
D87653 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1590
Phone
(410) 328-8141
Fax
(410) 328-0177
NPI assigned
Jun 18, 2012
Last updated
Jul 31, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D87653 MD
Critical Care Medicine (Internal Medicine) Physician 207RC0200X D87653 MD Primary
Pulmonary Disease Physician 207RP1001X D87653 MD
Sleep Medicine (Internal Medicine) Physician 207RS0012X D87653 MD

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1590

Mailing address

PO Box 64442
Baltimore, MD 21264-4442
Phone (410) 328-8040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190823000047 MD Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 5799061131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine, Pulmonary Disease
Education
University of Rochester School of Medicine and Dentistry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-8040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D87653MDMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Physicians PA Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients
University of Maryland Physicians P.a. CurrentSince Aug 1, 2019 Accepting new patients
University of Maryland Physicians P.a. Current Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

Interoperability endpoints

  • Direct secure messaging: jso642869@direct.umm.edu

Organizations & group practices 3

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 2

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": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1700149440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64442",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644442",
            "telephone_number": "410-328-8040",
            "fax_number": "443-462-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011590",
            "telephone_number": "410-328-8141",
            "fax_number": "410-328-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "JENNIFER",
        "middle_name": "Y",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D87653",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MD",
            "license": "D87653",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MD",
            "license": "D87653",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MD",
            "license": "D87653",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.