Individual provider Active NPI

Justin Jeffers

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Baltimore, MD
National Provider Identifier
1821215583
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
D74146 Issued in MD
Practice address
1800 Orleans St Ste 11379
Baltimore, MD 21287-0010
Phone
(410) 955-6143
Fax
(410) 614-7339
NPI assigned
Apr 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X LP00853 RI
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X D74146 MD Primary

Addresses

Primary practice location

1800 Orleans St Ste 11379
Baltimore, MD 21287-0010

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-6423

Other practice location 1

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-8450

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120809000074 MD Practitioner - Pediatric Medicine 2264688183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP00853RIMDPediatrics Physician
D74146MDMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Current Accepting new patients
Johns Hopkins University CurrentSince Aug 1, 2012 Accepting new patients
Johns Hopkins University Pediatric Emergency Medicine CurrentSince Aug 1, 2012 Accepting new patients

Locations

1800 Orleans St
Ste 11379
Baltimore, MD 21287
Phone (410) 955-8751

600 N Wolfe St
Baltimore, MD 21287

601 N Caroline St
Baltimore, MD 21287
Phone (410) 955-5080

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: jjeffers59220@direct.hopkinsmedicine.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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1821215583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ORLEANS ST STE 11379",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870010",
            "telephone_number": "410-955-6143",
            "fax_number": "410-614-7339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-8450",
            "fax_number": "401-444-5088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEFFERS",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "LP00853",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MD",
            "license": "D74146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.