Active NPI
Jerry Varghese, MD
- Internal Medicine Physician
- Baltimore, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35085028
- Practice address
- 7141 Security Blvd
Baltimore, MD 21244-1811 - Phone
- (443) 663-6000
- Fax
- (443) 663-6215
- NPI assigned
- Jan 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35085028 | OH | Primary |
Addresses
Primary practice location
7141 Security Blvd
Baltimore, MD 21244-1811
Mailing address
7141 Security Blvd
Baltimore, MD 21244-1811
Phone (443) 663-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2507755 | Medicaid | OH |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) | |
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Internal Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients |
Locations
7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600
7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700
2101 E Jefferson St
#4E
Rockville, MD 20852
2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853
2101 E Jefferson St
Rockville, MD 20852
Phone (301) 816-6660
1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500
7141 Security Blvd
Windsor Mill, MD 21244
Phone (410) 281-6200
Organizations & group practices 4
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.
-
- Health Maintenance Organization
- Halethorpe, MD
- NPI 1043378656
-
- Health Maintenance Organization
- Annapolis, MD
- NPI 1952461816
DC, Internal Medicine
-
- Health Maintenance Organization
- Glen Burnie, MD
- NPI 1285752121
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Rockville, MD
- NPI 1962108753
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623110400000",
"number": "1841279874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7141 SECURITY BLVD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212441811",
"telephone_number": "443-663-6000",
"fax_number": "443-663-6215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7141 SECURITY BLVD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212441811",
"telephone_number": "443-663-6000",
"fax_number": "443-663-6215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARGHESE",
"first_name": "JERRY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-09",
"last_updated": "2021-06-08",
"certification_date": "2021-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35085028",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2507755",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "2101 E Jefferson St",
"city": "Rockville",
"state": "MD",
"country_code": "US",
"postal_code": "20852",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "2101 E Jefferson St",
"city": "Rockville",
"state": "MD",
"country_code": "US",
"postal_code": "20852",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.