NPIMap

Organization Active NPI

Jaak Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • Pikesville, MD
National Provider Identifier
1831649573
Registry record updated Nov 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
R4000 Issued in MD
Legal business name
JAAK MEDICAL SUPPLY
Practice address
2 Reservoir Cir Ste 102
Pikesville, MD 21208-1391
Phone
(410) 978-8236
Fax
(410) 983-3950
NPI assigned
Oct 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2023

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

Authorized official

Name
Mr. Zinoviy Fradlin
Title
Administrator
Phone
(410) 629-5225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X R4000 MD Primary

Addresses

Primary practice location

2 Reservoir Cir Ste 102
Pikesville, MD 21208-1391

Mailing address

2 Reservoir Cir Ste 102
Pikesville, MD 21208-1391
Phone (410) 978-8236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171121001940 MD DME Supplier - Medical Supply Company 3870850167 Practice locations: Pikesville, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Jaak Medical Supply2 Reservoir Cir, Pikesville, MD 21208-1391(410) 978-8236 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Surgical Dressings|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jul 31, 2017

National Provider Directory

National Provider Directory

Locations

10 Crossroads Dr
Ste 117B
Owings Mills, MD 21117

10 Crossroads Dr
Unit 117B
Owings Mills, MD 21117
Phone (410) 978-8236

2 Reservoir Cir
Ste 102
Pikesville, MD 21208
Phone (410) 978-8236

1829 Reisterstown Rd
Ste 350303
Pikesville, MD 21208
Phone (410) 629-5225

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700784000000",
    "number": "1831649573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 RESERVOIR CIR STE 102",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212081391",
            "telephone_number": "410-978-8236",
            "fax_number": "410-983-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 RESERVOIR CIR STE 102",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212081391",
            "telephone_number": "410-978-8236",
            "fax_number": "410-983-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAAK MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-05",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A",
        "authorized_official_last_name": "FRADLIN",
        "authorized_official_first_name": "ZINOVIY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-629-5225",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "R4000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.