Active NPI
Jin Gu MD PA
- Internal Medicine Physician
- Towson, MD
National Provider Identifier
1811908817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- D56623
- Legal business name
- JIN GU MD PA
- Practice address
- 7505 Osler Dr
Suite 312
Towson, MD 21204-7736 - Phone
- (410) 828-8005
- Fax
- (410) 828-0537
- NPI assigned
- Aug 11, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jin Gu, MD
- Title
- Owner President
- Phone
- (410) 828-8005
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | D56623 | MD | Primary |
Addresses
Primary practice location
7505 Osler Dr
Suite 312
Towson, MD 21204-7736
Mailing address
7505 Osler Dr
Suite 312
Towson, MD 21204-7736
Phone (410) 828-8005
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60924901 | Other | BSMD PIN # | |
| F376 | Other | BSDC GROUP # | |
| 5004985 | Other | CGNA PIN # | |
| 7592182 | Other | ANHM GROUP # | |
| 004301000 | Medicaid | MD | |
| 0928824 | Other | KEYS GROUP # | |
| 2504440 | Other | AHMO PIN # | |
| 2504440 | Other | AHMO GROUP # | |
| 928824 | Other | BSPA GROUP # | |
| KEG4JI | Other | BSMD GROUP # | |
| 7592182 | Other | ANHM PIN # | |
| 81709 | Other | COV PIN # | |
| 0001 | Other | BSDC PIN # | |
| 5004985 | Other | CGNA GROUP # | |
| 81709 | Other | COV GROUP # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
7505 Osler Dr
Ste 312
Towson, MD 21204
Phone (410) 828-8005
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Towson, MD
- NPI 1154420727
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1324944000000",
"number": "1811908817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7505 OSLER DR",
"address_2": "SUITE 312",
"city": "TOWSON",
"state": "MD",
"postal_code": "212047736",
"telephone_number": "410-828-8005",
"fax_number": "410-828-0537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7505 OSLER DR",
"address_2": "SUITE 312",
"city": "TOWSON",
"state": "MD",
"postal_code": "212047736",
"telephone_number": "410-828-8005",
"fax_number": "410-828-0537"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JIN GU MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-11",
"last_updated": "2011-12-27",
"status": "A",
"authorized_official_last_name": "GU",
"authorized_official_first_name": "JIN",
"authorized_official_title_or_position": "OWNER PRESIDENT",
"authorized_official_telephone_number": "410-828-8005",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "MD",
"license": "D56623",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSMD PIN #",
"identifier": "60924901",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSDC GROUP #",
"identifier": "F376",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CGNA PIN #",
"identifier": "5004985",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANHM GROUP #",
"identifier": "7592182",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004301000",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYS GROUP #",
"identifier": "0928824",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHMO PIN #",
"identifier": "2504440",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHMO GROUP #",
"identifier": "2504440",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSPA GROUP #",
"identifier": "928824",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSMD GROUP #",
"identifier": "KEG4JI",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANHM PIN #",
"identifier": "7592182",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COV PIN #",
"identifier": "81709",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSDC PIN #",
"identifier": "0001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CGNA GROUP #",
"identifier": "5004985",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COV GROUP #",
"identifier": "81709",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Towson, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.