PRIMECARE PEDIATRICS (NPI# 1285757971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285757971 |
| Entity Type | Organization |
| Organization Name | PRIMECARE PEDIATRICS |
| Other Organization Name | JAY J GOPAL MD |
| Practice Address |
201 E University Pkwy 33rd St. Prof. Bldg., Suite 233 Baltimore MD 21218-2829 |
| Mailing Address |
201 E University Pkwy 33rd St. Prof., Bldg, Suite 233 Baltimore MD 21218-2829 |
| Practice Telephone | 4105542919 |
| Practice Fax Number | 4105542570 |
| Mailing Telephone | 4105542919 |
| Mailing Fax Number | 4105542570 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2010-04-02 |
| Authorized Official Name | DR. JAY J GOPAL (CEO) |
| Authorized Official Telephone | 4105542919 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | GR. GOPAL INDETUAL NPI # | 1407823776 | 01 |
| Other Name | Type Code |
|---|---|
| Jay J Gopal MD | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326117276 | Primecare Pediatrics | Non-Pharmacy Dispensing Site | 5820 York Rd, Ste 23, Baltimore, MD 21212-3610 | 2006-11-07 |
| Street Address |
201 E UNIVERSITY PKWY 33RD ST. PROF. BLDG., SUITE 233 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21218-2829 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396742946 | Shannon Seifert | Nurse Anesthetist, Certified Registered | 201 E University Pkwy, Baltimore, MD 21218-2829 | 2005-06-28 |
| 1619574159 | Brady Huttinger | Physician Assistant | 201 E University Pkwy, Baltimore, MD 21218-2829 | 2020-10-07 |
| 1285241976 | Stephanie Banks | Health Educator | 201 E University Pkwy, Baltimore, MD 21218-2829 | 2020-09-26 |
| 1366059149 | Sherri Lynn Harper | Community Health Worker | 201 E University Pkwy, Baltimore, MD 21218-2829 | 2020-09-25 |
| 1730793738 | Taha Khalid | Student in an Organized Health Care Education/Training Program | 201 E University Pkwy, Baltimore, MD 21218-2829 | 2020-09-07 |
| 1124632930 | Yogesh Subedi | Student in an Organized Health Care Education/Training Program | 201 E University Pkwy, Baltimore, MD 21218-2829 | 2020-08-31 |
| 1477167294 | Seejal Niraula | Student in an Organized Health Care Education/Training Program | 201 E University Pkwy, Baltimore, MD 21218-2829 | 2020-08-31 |
| 1942812698 | Diwakar Panta | Student in an Organized Health Care Education/Training Program | 201 E University Pkwy, Baltimore, MD 21218-2829 | 2020-08-22 |
| 1649882036 | Gaurav Raj Shrestha | Student in an Organized Health Care Education/Training Program | 201 E University Pkwy, Baltimore, MD 21218-2829 | 2020-08-18 |
| 1922610260 | Ngawang Dhonten | Student in an Organized Health Care Education/Training Program | 201 E University Pkwy, Baltimore, MD 21218-2829 | 2020-08-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851933725 | Tierra Bouyer | Speech-Language Pathologist | 2040 East 32nd Street, Baltimore, MD 21218 | 2019-10-12 |
| 1093273559 | Brenda H. Wells | Social Worker | 200 E. North Ave., Baltimore, MD 21218 | 2019-03-04 |
| 1619441011 | Harwood Behavioral Health Partners, LLC | Community/Behavioral Health | 2514 Greenmount Avenue, Baltimore, MD 21218 | 2019-01-18 |
| 1649740291 | Elise Christine Starkey | Occupational Therapist | 801 Argonne Drive, Baltimore, MD 21218 | 2018-11-27 |
| 1851861421 | Alagra S Bass | Social Worker | 1900 N. Howard Street Suite 300, Baltimore, MD 21218 | 2018-11-27 |
| 1396213575 | Desiree Luerene Israel | Social Worker | 2000 Greenmount Ave Ste 101, Baltimore, MD 21218 | 2018-11-06 |
| 1952885451 | Harwood Behavioral Health Partners, LLC | Clinic/Center | 2514 Greenmount Ave, Baltimore, MD 21218 | 2018-09-20 |
| 1528548047 | Rozi Khan | Student in an Organized Health Care Education/Training Program | 325 East University Pkwy 1-3, Bltimore, MD 21218 | 2018-08-14 |
| 1558866202 | Prabij N/a Dhungana | Student in an Organized Health Care Education/Training Program | 201 E. University Parkway, Dept of Medicine, Baltimore, MD 21218 | 2018-03-26 |
| 1588163562 | Generation 5 Healthcare, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 707 Belgian Ave., Baltimore, MD 21218 | 2018-02-06 |
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| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346582244 | Katherine Maureen Carlin | Pediatrics | Johns Hopkins School of Medicine, 733 North Broadway, Suite 147, Baltimore, MD 21205-2196 | 2013-03-19 |
| 1528198652 | Cheryl Lynn Parks | Pediatrics | 3527 N Rolling Rd, Suite 1, Baltimore, MD 21244-2223 | 2007-03-07 |
| 1205984796 | Michael L Zollicoffer | Pediatrics | 3502 W Rogers Ave Ste 8, Baltimore, MD 21215-4749 | 2007-01-08 |
| 1952465676 | Alain Joffe | Pediatrics | 3400 N. Charles Street, Johns Hopkins U. Student Health Center, Baltimore, MD 21218-2682 | 2006-12-20 |
| 1710954326 | Kathleen A. Awalt | Pediatrics | 8600 Lasalle Rd, Potomac Building Suite 105, Baltimore, MD 21286-2001 | 2006-03-02 |
| 1841281706 | Carol Ivy Reynolds-freeman | Pediatrics | 4 W Rolling Crossroads, Suite 100, Baltimore, MD 21228-6280 | 2005-10-31 |
| 1659903920 | Tellerman & Associates, LLC | Pediatrics | 711 W 40th St Ste 438, Baltimore, MD 21211-2199 | 2020-02-05 |
| 1689131575 | Johns Hopkins University | Pediatrics | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2019-02-27 |
| 1366707192 | Steven E. Caplan, M.d. P.a. | Pediatrics | 2411 W Belvedere Ave, Suite 508, Baltimore, MD 21215-5228 | 2012-07-09 |
| 1568603397 | Robert William Blum | Pediatrics | 615 N Wolfe St, Baltimore, MD 21205-2103 | 2009-03-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.