NPIMap

Individual provider Active NPI

Jason R. Dittrich, M.D.

  • Vascular & Interventional Radiology Physician
  • Annapolis, MD
National Provider Identifier
1902897895
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
D0058803 Issued in MD
Practice address
2002 Medical Pkwy
Suite #235
Annapolis, MD 21401-3046
Phone
(410) 266-2770
Fax
(410) 841-6251
NPI assigned
Oct 31, 2005
Last updated
Nov 13, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X D0058803 MD Primary

Addresses

Primary practice location

2002 Medical Pkwy
Suite #235
Annapolis, MD 21401-3046

Mailing address

2002 Medical Pkwy
Suite #235
Annapolis, MD 21401-3046
Phone (410) 266-2770

Other identifiers 8

IdentifierTypeStateIssuer
10690026OtherMDBCBS
8317071OtherMDAETNA PPO
G01780A06OtherMDAAD PG COUNTY
2622593OtherMDAETNA HMO/POS
434340900MedicaidMD
545L E502OtherMDAAD SHIPLEYS
E488OtherMDAAD AA COUNTY
300134259OtherMDRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041229000085 DC Practitioner - Diagnostic Radiology 4385602911 Reassigns benefits to 2 organizations
I20050324000284 MD Practitioner - Diagnostic Radiology 4385602911 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Southwestern Medical School at Dallas, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luminis Health Imaging, Inc.Group PAC ID 8729054598, 22 clinicians
Meritus Medical Center IncGroup PAC ID 7113811795, 730 clinicians
Brown, Croft, Frazier, PAGroup PAC ID 9537101746, 28 clinicians

Practice addresses (Care Compare)

1106 Annapolis Rd
Suite 110
Odenton, MD 21113-1738
Phone (443) 481-6767

122 Seahawk LN
Edgewater, MD 21037-2772
Phone (301) 790-8000

2000 Medical Pkwy
Suite 202
Annapolis, MD 21401-3742

2000 Medical Pkwy
Suite 202
Annapolis, MD 21401-3744
Phone (443) 481-5660

2002 Medical Pkwy
Annapolis, MD 21401-3046
Phone (443) 481-5330

4175 N Hanson CT
Bowie, MD 20716-3179
Phone (443) 481-3260

8116 Good Luck Rd
Suite 101
Lanham, MD 20706-3513
Phone (443) 481-5335

8118 Good Luck Rd
Lanham, MD 20706-3574
Phone (410) 266-2770

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0058803MDMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meritus Medical Center Inc CurrentSince Jan 10, 2025 Accepting new patients
Meritus Medical Center Inc CurrentSince Jan 10, 2025 Accepting new patients
Luminis Health Imaging, Inc. CurrentSince Oct 1, 2000 Accepting new patients
Meritus Medical Center Inc Current Accepting new patients
Luminis Health Imaging, Inc. CurrentSince Jul 1, 2002 Accepting new patients
Brown, Croft, Frazier, PA Vascular & Interventional Radiology CurrentSince Jul 20, 2002 Accepting new patients
Nighttime Radiology LLC Past Accepting new patients
Radiology Associates of Dothan PC Vascular & Interventional Radiology Past Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Vascular & Interventional Radiology Past Accepting new patients
University Imaging Center, LLC Vascular & Interventional Radiology Past Accepting new patients
David L Bloom PA Past Accepting new patients
David L Bloom PA Past Accepting new patients
Shipley's Imaging, LLC Past Accepting new patients
University Imaging Center, LLC Vascular & Interventional Radiology Past Accepting new patients

Locations

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

2002 Medical Pkwy
Annapolis, MD 21401
Phone (443) 481-4915

2002 Medical Pkwy
Ste 100
Annapolis, MD 21401
Phone (443) 481-4915

2002 Medical Pkwy
Ste 235
Annapolis, MD 21401

4175 N Hanson Ct
Bowie, MD 20716
Phone (301) 464-0798

2108 Red Apple Plz
Chester, MD 21619
Phone (410) 643-6205

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

8118 Good Luck Rd
Lanham Seabrook, MD 20706
Phone (301) 552-8608

8601 Veterans Hwy
Ste 100
Millersville, MD 21108
Phone (410) 729-4450

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 4

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1902897895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY",
            "address_2": "SUITE #235",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013046",
            "telephone_number": "410-266-2770",
            "fax_number": "410-841-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY",
            "address_2": "SUITE #235",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013046",
            "telephone_number": "410-266-2770",
            "fax_number": "410-841-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTRICH",
        "first_name": "JASON",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MD",
            "license": "D0058803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10690026",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "8317071",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAD PG COUNTY",
            "identifier": "G01780A06",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO/POS",
            "identifier": "2622593",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "434340900",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAD SHIPLEYS",
            "identifier": "545L E502",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAD AA COUNTY",
            "identifier": "E488",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "300134259",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.