NPIMap

Individual provider Active NPI

Deborah Anthony Jack, MD

  • Internal Medicine Physician
  • Silver Spring, MD
National Provider Identifier
1750919924
Registry record updated Jun 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0097198 Issued in MD
Practice address
11890 Healing Way
Silver Spring, MD 20904-7917
Phone
(240) 637-4000
NPI assigned
Mar 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X D0097198 MD Primary

Addresses

Primary practice location

11890 Healing Way
Silver Spring, MD 20904-7917

Mailing address

11013 Lake Victoria LN
Bowie, MD 20720-4272
Phone (240) 281-9613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230906003300 DC Practitioner - Internal Medicine 0749644961 Reassigns benefits to 1 organization
I20251211000426 MD Practitioner - Internal Medicine 0749644961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Howard University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Integrated Acute Care Services of Maryland LLCGroup PAC ID 4486900172, 178 clinicians

Practice addresses (Care Compare)

100 Hospital Rd
Prince Frederick, MD 20678-4017
Phone (410) 535-8344

11711 Livingston Rd
Fort Washington, MD 20744-5151
Phone (301) 203-2250

219 S Washington St
Easton, MD 21601-2913
Phone (410) 822-1000

9901 Medical Ctr Dr
Rockville, MD 20850-3357
Phone (240) 826-7578

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
72.91 of 100Reported as group
Quality
50.88
Improvement activities
40
Cost
69.9

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
76.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0097198MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates, PA CurrentSince Dec 2, 2025 Accepting new patients

Locations

100 Hospital Rd
Prnc Frederck, MD 20678
Phone (410) 414-4791

Interoperability endpoints

  • Direct secure messaging: djack161632@direct.aahs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687046400000",
    "number": "1750919924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11013 LAKE VICTORIA LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204272",
            "telephone_number": "240-281-9613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11890 HEALING WAY",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209047917",
            "telephone_number": "240-637-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "DEBORAH",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2023-06-18",
        "certification_date": "2023-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0097198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.