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

Dr. Jonathan Ethan Tannebaum, MD

Individual provider Surgery Physician · NPI 1285922724

Dr. Jonathan Ethan Tannebaum, MD is a General Surgery in Oakland, Maryland. Graduated from Jefferson Medical College of Thomas Jefferson University in 2009, 17 years ago. Practices with Specialty Physicians of Garrett County, LLC, a 84-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
17
Trained at
Jefferson Medical College of Thomas Jefferson University
Licensed in
NY
In the registry since
2011
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

251 N 4th St
Oakland, MD 21550-1375
Phone: (301) 533-4000
Fax: (301) 895-8751
Show map & directions

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

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 275818 (NY)

Record details

NPI number1285922724
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 19, 2011
Last updated in NPPESAugust 16, 2021
Certification dateAugust 16, 2021
Mailing address908 Niagara Falls Blvd Ste 208, North Tonawanda, NY 14120-2019

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolJEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Graduated 2009 (17 years in practice)
Group practice Specialty Physicians Of Garrett County, Llc — 84 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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