NPIMap

Individual provider Active NPI

Jamal A Mikdashi, M.D.

  • Rheumatology Physician
  • Baltimore, MD
National Provider Identifier
1891762126
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
D38046 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 706-6474
Fax
(410) 706-0231
NPI assigned
Mar 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X D38046 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

PO Box 64442
Baltimore, MD 21264-4442
Phone (410) 706-6474

Other identifiers 4

IdentifierTypeStateIssuer
525809-02OtherMDBLUE CROSS/BLUE SHIELD
037523500MedicaidDC
1891762126MedicaidDE
759111000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090521000110 MD Practitioner - RheumatologyPractitioner - Internal Medicine 6002981784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Maryland Physicians PAGroup PAC ID 2769394808, 395 clinicians

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-5196

Hospital & facility affiliations

  • University of Maryland Medical Center Hospital, Baltimore, MD, CCN 210002
  • University of MD Medical Center Midtown Campus Hospital, Baltimore, MD, CCN 210038

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Physicians PA Rheumatology CurrentSince Jul 1, 1995 Accepting new patients
University of Maryland Physicians P.a. Current Accepting new patients
University of Maryland Physicians P.a. CurrentSince Jul 1, 1995 Accepting new patients
University of Maryland Physicians P.a. Current Accepting new patients
University of Maryland Physicians PA Rheumatology Current Accepting new patients
Grace Medical Center, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
University of Maryland Family Medicine Associates, P.a. Past Accepting new patients
University Care Past Accepting new patients
University Care LLC Rheumatology Past Accepting new patients

Locations

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

419 W Redwood St
Baltimore, MD 21201
Phone (410) 328-5196

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

16 S Eutaw St
Fl 2
Baltimore, MD 21201
Phone (410) 328-3335

419 W Redwood St
Ste 220
Baltimore, MD 21201
Phone (410) 328-3306

219 S Washington St
Easton, MD 21601

Interoperability endpoints

  • Direct secure messaging: jmikdashi476@direct.umm.edu

Organizations & group practices 10

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": "1141603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1891762126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64442",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644442",
            "telephone_number": "410-706-6474",
            "fax_number": "410-706-0231"
        },
        {
            "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": "410-706-6474",
            "fax_number": "410-706-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKDASHI",
        "first_name": "JAMAL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-06",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MD",
            "license": "D38046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "525809-02",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037523500",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891762126",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "759111000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.