Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Farrukh Mahfuz Jalisi, MD

Individual provider Internal Medicine Physician · NPI 1174621346

Dr. Farrukh Mahfuz Jalisi, MD is an Interventional Cardiology in Glen Burnie, Maryland. Qualified in 1994, 32 years ago. Practices with Princeton Community Hospital Assn Inc, a 175-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Indiana, Maryland, New York and Virginia and 1 more.

Years since qualifying
32
Licensed in
IN, MD, NY, VA, WV
In the registry since
2006
Specialties on file
11
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

7845 Oakwood Rd Ste 106
Glen Burnie, MD 21061-4256
Phone: (410) 760-5100
Fax: (410) 760-5932
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 12502 Willowbrook Rd, Cumberland, MD 21502-6491 — (240) 964-8740
  • 7601 Osler Dr, Towson, MD 21204-7700 — (410) 427-2580

Specialties & licences

Interventional Cardiology Physician (primary) Taxonomy 207RI0011X · Licence D84429 (MD)
Internal Medicine Physician Taxonomy 207R00000X · Licence 20266 (WV)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 241683 (NY)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 20266 (WV)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence D84429 (MD)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 0101247118 (VA)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 01065461 (IN)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence 20266 (WV)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence 0101247118 (VA)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence 01065461 (IN)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence 241683 (NY)

Record details

NPI number1174621346
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 20, 2006
Last updated in NPPESDecember 27, 2024
Certification dateDecember 27, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERVENTIONAL CARDIOLOGY
Also practisesCARDIOVASCULAR DISEASE (CARDIOLOGY)
Medical schoolOTHER
Graduated 1994 (32 years in practice)
Group practice Princeton Community Hospital Assn. Inc. — 175 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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