Individual provider Active NPI

Jeffrey Thomas Pacheco, MD

  • Specialist
  • Glen Burnie, MD
National Provider Identifier
1902804917
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D00061090 Issued in MD
Practice address
802 Landmark Dr
Ste 119
Glen Burnie, MD 21061
Phone
(410) 760-8840
Fax
(410) 760-7864
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D00061090 MD Primary
Otolaryngology Physician 207Y00000X D0061090 MD

Addresses

Primary practice location

802 Landmark Dr
Ste 119
Glen Burnie, MD 21061

Mailing address

802 Landmark Dr Ste 119
Glen Burnie, MD 21061-9121
Phone (410) 760-8840

Other identifiers 1

IdentifierTypeStateIssuer
001232700MedicaidMD

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
I20040607000098 MD Practitioner - Otolaryngology 9335121946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Miami, LM Miller School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11085 Little Patuxent Pkwy
Suite 101
Columbia, MD 21044-2914
Phone (410) 760-8840

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.02 of 100Reported as group
Quality
65.13
Promoting interoperability
98
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D00061090MDMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Regional Physicians LLC Current Accepting new patients
Johns Hopkins Regional Physicians LLC CurrentSince Nov 1, 2017 Accepting new patients
Johns Hopkins Regional Physicians LLC Otolaryngology CurrentSince Nov 1, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

129 Lubrano Dr
Ste L100
Annapolis, MD 21401
Phone (240) 274-1377

11085 Little Patuxent Pkwy
Ste 101
Columbia, MD 21044
Phone (410) 997-7979

10710 Charter Dr
Ste 400
Columbia, MD 21044
Phone (410) 997-7979

802 Landmark Dr
Ste 119
Glen Burnie, MD 21061
Phone 4107608840203

203 Hospital Dr
Ste 200
Glen Burnie, MD 21061
Phone (410) 553-8362

14201 Laurel Park Dr
Ste 115
Laurel, MD 20707
Phone (301) 490-8083

1300 York Rd
Ste 30D
Lutherville Timonium, MD 21093
Phone (443) 275-1337

1132 Annapolis Rd
Ste 106
Odenton, MD 21113

Interoperability endpoints

  • Direct secure messaging: jpacheco51090@direct.hopkinsmedicine.org

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.

Hospital & facility affiliations 1

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1902804917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 LANDMARK DR STE 119",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210619121",
            "telephone_number": "410-760-8840",
            "fax_number": "410-760-7864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 LANDMARK DR",
            "address_2": "STE 119",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-760-8840",
            "fax_number": "410-760-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "JEFFREY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D00061090",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D0061090",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001232700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.