Individual provider Active NPI

Jesse Vasques Mesenburg, FNP-C

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1760994610
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1760994610 Issued in MD
Practice address
1200 E Fayette St
Baltimore, MD 21202-4721
Phone
(410) 396-9410
NPI assigned
Nov 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1760994610 MD Primary

Addresses

Primary practice location

1200 E Fayette St
Baltimore, MD 21202-4721

Mailing address

1200 E Fayette St
Baltimore, MD 21202-4721
Phone (410) 396-9410

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180316000376 MD Practitioner - Nurse Practitioner 8224390919 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1760994610MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Current Accepting new patients
Johns Hopkins University CurrentSince Feb 22, 2018 Accepting new patients
Johns Hopkins University CurrentSince Feb 22, 2018 Accepting new patients

Locations

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

Interoperability endpoints

  • Direct secure messaging: jmesenburg676684@direct.ochin.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.

NPI Registry JSON

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1760994610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E FAYETTE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024721",
            "telephone_number": "410-396-9410",
            "fax_number": "410-396-9437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E FAYETTE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024721",
            "telephone_number": "410-396-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESENBURG",
        "first_name": "JESSE",
        "middle_name": "VASQUES",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "1760994610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.