Individual provider Active NPI

Jeffrey T Hirata, MD

  • Diagnostic Radiology Physician
  • Annapolis, MD
National Provider Identifier
1740312149
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D0064802 Issued in MD
Practice address
2002 Medical Pkwy
Suite 235
Annapolis, MD 21401-3046
Phone
(410) 266-2770
Fax
(410) 841-6251
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X A102941 CA
Diagnostic Radiology Physician 2085R0202X D0064802 MD Primary

Addresses

Primary practice location

2002 Medical Pkwy
Suite 235
Annapolis, MD 21401-3046

Mailing address

2002 Medical Pkwy
Suite 235
Annapolis, MD 21401-3046
Phone (410) 266-2770

Other identifiers 9

IdentifierTypeStateIssuer
S645OtherMDMEDICARE AAD
1863725OtherMDAAD AMERIGROUP
1073OtherMDBCBS AAD
G0178OtherMDMEDICARE AAD
K606ANOtherMEAAD BOWIE
154158ZDYCOtherMEARA MEDICARE GROUP PTAN
764801400OtherMDMEDICAID AAD
417295700OtherMDAAD MEDICAL ASSISTANCE
1069OtherMDBCBS ARA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090625000432 MD Practitioner - Diagnostic Radiology 4789742362 Reassigns benefits to 4 organizations
I20090701000059 DC Practitioner - Diagnostic Radiology 4789742362 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Maryland School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brown, Croft, Frazier, PAGroup PAC ID 9537101746, 28 clinicians
Luminis Health Imaging, Inc.Group PAC ID 8729054598, 22 clinicians

Practice addresses (Care Compare)

15225 Shady Grove Rd
Suite 105
Rockville, MD 20850-3201
Phone (888) 601-0943

2001 Medical Pkwy
Annapolis, MD 21401-3773
Phone (410) 266-2770

2002 Medical Pkwy
Annapolis, MD 21401-3046
Phone (443) 481-5330

20528 Boland Farm Rd
Suite 110
Germantown, MD 20876-4032
Phone (888) 601-0943

325 Thomas Rd
Severna Park, MD 21146-2115
Phone (888) 601-0943

4175 N Hanson CT
Bowie, MD 20716-3179
Phone (443) 481-3260

8118 Good Luck Rd
Lanham, MD 20706-3574
Phone (410) 266-2770

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A102941CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Medical Imaging PA Diagnostic Radiology CurrentSince Jan 10, 2024 Accepting new patients
Brown, Croft, Frazier, PA Diagnostic Radiology CurrentSince Sep 3, 2013 Accepting new patients
Meritus Medical Center Inc CurrentSince Jan 24, 2025 Accepting new patients
Luminis Health Imaging, Inc. Diagnostic Radiology CurrentSince Sep 1, 2013 Accepting new patients
Meritus Medical Center Inc Diagnostic Radiology CurrentSince Jan 24, 2025 Accepting new patients
Meritus Medical Center Inc Current Accepting new patients
Luminis Health Imaging, Inc. Diagnostic Radiology CurrentSince Sep 1, 2013 Accepting new patients
Community Radiology Associates Inc Diagnostic Radiology PastSince Nov 17, 2024 Accepting new patients
Community Radiology Associates Inc Diagnostic Radiology PastSince Oct 27, 2024 Accepting new patients

Locations

2002 Medical Pkwy
Ste 100
Annapolis, MD 21401
Phone (443) 481-4915

2002 Medical Pkwy
Annapolis, MD 21401
Phone (443) 481-4915

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

2002 Medical Pkwy
Ste 235
Annapolis, MD 21401

4175 N Hanson Ct
Bowie, MD 20716
Phone (301) 464-0798

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

8118 Good Luck Rd
Lanham Seabrook, MD 20706
Phone (301) 552-8608

Organizations & group practices 10

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1740312149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY",
            "address_2": "SUITE 235",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013046",
            "telephone_number": "410-266-2770",
            "fax_number": "410-841-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY",
            "address_2": "SUITE 235",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013046",
            "telephone_number": "410-266-2770",
            "fax_number": "410-841-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRATA",
        "first_name": "JEFFREY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A102941",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0064802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE AAD",
            "identifier": "S645",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAD AMERIGROUP",
            "identifier": "1863725",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AAD",
            "identifier": "1073",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE AAD",
            "identifier": "G0178",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAD BOWIE",
            "identifier": "K606AN",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARA MEDICARE GROUP PTAN",
            "identifier": "154158ZDYC",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AAD",
            "identifier": "764801400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAD MEDICAL ASSISTANCE",
            "identifier": "417295700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ARA",
            "identifier": "1069",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.