| NPI | 1275950396 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2014-03-26 |
| Last Updated | 2021-06-20 |
| Mailing Address | 2101 E Jefferson St Ste 6w Rockville, MD 20852-4908 United States Phone: (301) 816-5853 📍 View Map |
| Primary Practice Address | 1221 Mercantile Ln Upper Marlboro, MD 20774-5374 United States Phone: (301) 618-5500 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 207Q00000X – Family Medicine | DC | MD045539 |
| No | 207Q00000X – Family Medicine | VA | 0102205000 |
| Yes | 207Q00000X – Family Medicine | MD | H83783 |
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About NPI 1275950396
Jericho De Mata D.O. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1275950396. The primary specialty listed is Family Medicine. The provider is located in Upper Marlboro, MD. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2014-03-26. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1275950396?
NPI 1275950396 belongs to Jericho De Mata D.O., a Family Medicine in Upper Marlboro, MD. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1275950396 active?
The current status of NPI 1275950396 in the NPPES registry is Active. The record was last updated on 2021-06-20.
What specialty is NPI 1275950396?
NPI 1275950396 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1275950396?
You can verify NPI 1275950396 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1275950396?
The primary practice address on file for NPI 1275950396 is 1221 Mercantile Ln, Upper Marlboro, MD 20774-5374. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1275950396 issued?
NPI 1275950396 was first issued (enumerated) on 2014-03-26. The NPPES record was last updated on 2021-06-20.
Practice Location Map
Jericho De Mata is located at 1221 Mercantile Ln, Upper Marlboro, MD. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Jericho De Mata. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1275950396. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Family Medicine | MD045539 | DC |
| Family Medicine | 0102205000 | VA |
| Family Medicine | H83783 | MD |