Jessa Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

R1058 Issued in MD

Legal business name

JESSA MEDICAL SUPPLY, INC.

Practice address

235 Kentlands Blvd
Gaithersburg, MD 20878-5446

Phone

(301) 990-8706

Fax

(240) 631-7113

NPI assigned

May 24, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Muse Aliyev

Title

President

Phone

(301) 990-8706

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

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

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708992000000",
    "number": "1720033913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 KENTLANDS BLVD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208785446",
            "telephone_number": "301-990-8706",
            "fax_number": "240-631-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 KENTLANDS BLVD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208785446",
            "telephone_number": "301-990-8706",
            "fax_number": "240-631-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSA MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A",
        "authorized_official_last_name": "ALIYEV",
        "authorized_official_first_name": "MUSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-990-8706",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "R1058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363570800",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009109668",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Jeffers
• Jeffrey Y.H. Chung, L.L.C.
• Seungye Jeon
• Jeremy J. Janssen, M.D., P.C.
• Marley Jerome-Featherson, LCSW-C
• Farjana Jewel
• Hong Ji, L.AC
• Fujiu Jia, LMT
• Junyong Jia, M.D.
• Queenie Jiang

• Durable Medical Equipment & Medical Supplies in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Durable Medical Equipment & Medical Supplies in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.