Jessica Shackman, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

D0081355 Issued in MD

Practice address

5755 Cedar LN
Columbia, MD 21044-2912

Phone

(410) 740-7890

NPI assigned

Apr 23, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Emergency Medicine

Education

University of Wisconsin School of Medicine, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johns Hopkins Howard County Medical Center Hospital, Columbia, MD, CCN 210048

Merit-based Incentive Payment System (MIPS)

Final score

83.31 of 100Reported as group

Quality

73.89

Promoting interoperability

100

Improvement activities

40

Cost

70.47

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jshackman304793@direct.hopkinsmedicine.org

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.

• Johns Hopkins University

  • Pain Medicine (Anesthesiology) Physician
  • Baltimore, MD
  • NPI 1922008549
  Medicare reassignment Care Compare group NPD
• Johns Hopkins University

  • Ophthalmology Physician
  • Belcamp, MD
  • NPI 1376342774
  NPD
• Johns Hopkins University

  • Emergency Medicine Physician
  • Baltimore, MD
  • NPI 1386631810
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Howard County General Hospital, Inc,

  • General Acute Care Hospital
  • Columbia, MD
  • NPI 1144291899
  Care Compare affiliation

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1992149744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 CEDAR LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442912",
            "telephone_number": "410-740-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKMAN",
        "first_name": "JESSICA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-23",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D81355",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0081355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "D81355",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latoya S. Sewell, CRNP
• Starsha Sewell
• Zewdnesh Seyoum, MD
• Rawan Shaat
• Cleo Shackelford, RBT
• Shadi Ghozati D.D.S. PA
• Tahmineh Ann Shadkhoo, LCPC
• Amanda Louise Shafer, MSN, CRNP, FNP-C
• Jawedullah Shafiq
• Deepak A. Shah, MD

• Emergency Medicine Physician in Columbia, MD
• Providers in Columbia, MD by specialty
• Emergency Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.
• 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.