NPIMap

Organization Active NPI

Leo I. Korotki, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Baltimore, MD
National Provider Identifier
1053371617
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
D0024017 Issued in MD
Legal business name
LEO I. KOROTKI, M.D.
Practice address
21 West Rd
Suite 105
Baltimore, MD 21204-2325
Phone
(410) 823-9333
Fax
(410) 823-9335
NPI assigned
Mar 27, 2006
Last updated
Jun 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Leo Israel Korotki, M.D.NPI 1710984232
Title
Owner
Phone
(410) 823-9333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X D0024017 MD Primary

Addresses

Primary practice location

21 West Rd
Suite 105
Baltimore, MD 21204-2325

Mailing address

21 West Rd
Suite 105
Baltimore, MD 21204-2325
Phone (410) 823-9333

Other identifiers 2

IdentifierTypeStateIssuer
218835OtherMDALLIANCE
5037OtherMDBLUE CROSS/BLUE SHIELD

Other names 1

  • Pain and Wellness Center Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1053371617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WEST RD",
            "address_2": "SUITE 105",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212042325",
            "telephone_number": "410-823-9333",
            "fax_number": "410-823-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WEST RD",
            "address_2": "SUITE 105",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212042325",
            "telephone_number": "410-823-9333",
            "fax_number": "410-823-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEO I. KOROTKI, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "KOROTKI",
        "authorized_official_first_name": "LEO",
        "authorized_official_middle_name": "ISRAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-823-9333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "D0024017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE",
            "identifier": "218835",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "5037",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain and Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.