| Jai Medical Center/ Park Heights | |
|
4340 Park Heights Ave Baltimore MD 21215-6725 | |
| (410) 542-8130 | |
| (410) 542-1826 |
| Full Name | Jai Medical Center/ Park Heights |
|---|---|
| Speciality | Family Medicine |
| Location | 4340 Park Heights Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Jai M Seunarine (CEO) |
| Authorized Official Contact | 4104332200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jai Medical Center/ Park Heights 5010 York Rd Baltimore MD 21212-4437 Ph: (410) 433-2200 | Jai Medical Center/ Park Heights 4340 Park Heights Ave Baltimore MD 21215-6725 Ph: (410) 542-8130 |
| NPI Number | 1639101462 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 04/10/2020 |
| Medicare PECOS PAC ID | 7012012651 |
|---|---|
| Medicare Enrollment ID | O20070410000531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639101462 | NPI | - | NPPES |
| K614PA | Other | MD | BLUECROSS/BLUESHEILD MD |
| 069231000 | Medicaid | MD | |
| 1347 | Other | MD | JAI MEDICAL SYSTEM MCO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DOO14391 (Maryland) | Primary |
| Provider Name | Nalayini Sivaraman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649200320 PECOS PAC ID: 2163424185 Enrollment ID: I20070205000322 |
| Provider Name | Samantha Kite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104016948 PECOS PAC ID: 6901970540 Enrollment ID: I20080731000148 |
| Provider Name | Teri R Richardson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184659088 PECOS PAC ID: 3072701325 Enrollment ID: I20101230000597 |
| Provider Name | Francis A Bird |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386674018 PECOS PAC ID: 1557550381 Enrollment ID: I20110111000079 |
| Provider Name | Yulia Goldfarb |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588694293 PECOS PAC ID: 9931398476 Enrollment ID: I20110113000963 |
| Provider Name | Oyebukola A Grant |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568641561 PECOS PAC ID: 3173611936 Enrollment ID: I20111111000151 |
| Provider Name | Kenyatta Hough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669820957 PECOS PAC ID: 4082908439 Enrollment ID: I20160808000505 |
| Provider Name | Ibiyinka Windapo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518407451 PECOS PAC ID: 8527336387 Enrollment ID: I20170620000787 |
| Provider Name | Kathyann M Gibbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083871107 PECOS PAC ID: 6002177409 Enrollment ID: I20180227002953 |
| Provider Name | Christina Foreman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629585260 PECOS PAC ID: 1456612373 Enrollment ID: I20180309000486 |
| Provider Name | Maria Moyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386671139 PECOS PAC ID: 5799784500 Enrollment ID: I20190205002132 |
| Provider Name | Ali Minhal Thaver |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962819458 PECOS PAC ID: 6204107741 Enrollment ID: I20190819003157 |
| Provider Name | Eric B Goldschmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043852478 PECOS PAC ID: 6608200506 Enrollment ID: I20191231002400 |
| Provider Name | Olayinka Ajomagberin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447808613 PECOS PAC ID: 3274968425 Enrollment ID: I20200115002542 |
| Provider Name | Jennifer M Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225564305 PECOS PAC ID: 2466727789 Enrollment ID: I20200210001955 |
| Provider Name | Stacy R Hoenes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467916148 PECOS PAC ID: 8921439159 Enrollment ID: I20200504000345 |
| Provider Name | Nastassja Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720769359 PECOS PAC ID: 6507210218 Enrollment ID: I20230929000368 |
| Provider Name | Musa M Mivanyi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821612466 PECOS PAC ID: 8628425733 Enrollment ID: I20231111000290 |
Empowerment Healthcare Systems,llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9106 Philadelphia Rd Ste 108b, Baltimore, MD 21237 Phone: 410-321-1961 Fax: 410-321-1962 | |
Fresh Start Comprehensive Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11 E Mount Royal Ave # Ll, Baltimore, MD 21202 Phone: 443-671-1414 Fax: 443-671-1420 | |
Gbmc Health Partners At Jonestown Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1017 E Baltimore St, Ground Floor, Baltimore, MD 21202 Phone: 410-826-0170 | |
Admin Location Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2024 E Monument St Ste 2626, Baltimore, MD 21287 Phone: 410-933-6430 | |
Plume Health Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 E Pratt St, Baltimore, MD 21202 Phone: 720-248-4483 | |
Np Medical Solutions By Sheila Waller Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5119 Mcfaul Rd, Baltimore, MD 21206 Phone: 443-531-6248 | |
Health Care For The Homeless, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 421 Fallsway, Baltimore, MD 21202 Phone: 410-837-5533 Fax: 410-837-8020 |