Individual provider Active NPI

Jacqueline Marie Robinson

  • Trauma Surgery Physician
  • Baltimore, MD
National Provider Identifier
1780170753
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
D0100112 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(667) 234-6000
NPI assigned
Jul 2, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0127X D0100112 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

22 S Greene St
Baltimore, MD 21201-1544
Phone (248) 508-1581

Other identifiers 1

IdentifierTypeStateIssuer
52-0591657MedicaidMD

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
I20241104003549 MD Practitioner - Critical Care (Intensivists) 6901339563 Reassigns benefits to 1 organization
I20250116003306 DC Practitioner - General Surgery 6901339563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shock Trauma Associates PAGroup PAC ID 6800882317, 258 clinicians

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-6704

Hospital & facility affiliations

  • University of Maryland Medical Center Hospital, Baltimore, MD, CCN 210002
  • Umd Upper Chesapeake Medical Center Hospital, Bel Air, MD, CCN 210049

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0100112MDMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dimensions Healthcare Associates Inc Multi-Specialty CurrentSince Nov 8, 2024 Accepting new patients
Shock Trauma Associates, P.a. Multi-Specialty CurrentSince Aug 19, 2024 Accepting new patients
Dimensions Health Associates Dba University of Maryland Capital Region Multi-Specialty CurrentSince Nov 8, 2024 Accepting new patients
Dimensions Healthcare Associates, Inc. Multi-Specialty Current Accepting new patients
University of Maryland Medical Center, LLC Multi-Specialty Past Accepting new patients
Dimensions Healthcare Associates Inc Multi-Specialty Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

2900 Mercy Ln
Cheverly, MD 20785
Phone (301) 618-2010

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

251 National Harbor Blvd
Fl 5
Oxon Hill, MD 20745
Phone (301) 618-2273

901 Harry S Truman Dr N
Uppr Marlboro, MD 20774
Phone (240) 677-0021

Organizations & group practices 6

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 2

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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1780170753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "248-508-1581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "667-234-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": "MD",
            "license": "D0100112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52-0591657",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.