Individual provider Active NPI

Jeremy David Stillman, PA-C

  • Surgical Physician Assistant
  • Washington, DC
National Provider Identifier
1770902157
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA031027 Issued in DC
Practice address
900 23Rd St NW
Washington, DC 20037-2342
Phone
(202) 715-4000
NPI assigned
Apr 14, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA031027 DC
Surgical Physician Assistant 363AS0400X PA031027 DC Primary

Addresses

Primary practice location

900 23Rd St NW
Washington, DC 20037-2342

Mailing address

900 23Rd St NW
Washington, DC 20037-2342
Phone (202) 715-4033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20140729000943 DC Practitioner - Physician Assistant 9335365352 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Faculty Associates, IncGroup PAC ID 4082528898, 676 clinicians

Practice addresses (Care Compare)

900 23Rd St NW
Washington, DC 20037-2342
Phone (202) 715-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA031027DCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
District Hospital Partners L P CurrentSince Mar 31, 2019 Accepting new patients
District Hospital Partners LP CurrentSince Mar 31, 2019 Accepting new patients

Locations

2300 M St NW
Washington, DC 20037
Phone (202) 741-2222

2300 M St NW
Fl 4
Washington, DC 20037
Phone (202) 741-3250

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

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 1

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": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1770902157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 23RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200372342",
            "telephone_number": "202-715-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 23RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200372342",
            "telephone_number": "202-715-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLMAN",
        "first_name": "JEREMY",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-14",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA031027",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "DC",
            "license": "PA031027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.