Individual provider Active NPI

Brenda Elizabeth Tester, DO

  • Internal Medicine Physician
  • Bel Air, MD
National Provider Identifier
1114598778
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
H0107137 Issued in MD
Practice address
500 Upper Chesapeake Dr
Bel Air, MD 21014-4324
Phone
(443) 949-0814
Fax
(443) 949-0825
NPI assigned
Jul 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X H0107137 MD Primary

Addresses

Primary practice location

500 Upper Chesapeake Dr
Bel Air, MD 21014-4324

Mailing address

500 Upper Chesapeake Dr
Bel Air, MD 21014-4324
Phone (443) 949-0814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260623000165 MD Practitioner - Internal Medicine 7618440587

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1413 Hwy 17 S
Suite 307
Surfside Beach, SC 29575-6040

PO Box
Suite 69453
Baltimore, MD 21264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
125.081302ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1114598778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UPPER CHESAPEAKE DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144324",
            "telephone_number": "443-949-0814",
            "fax_number": "443-949-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UPPER CHESAPEAKE DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144324",
            "telephone_number": "443-949-0814",
            "fax_number": "443-949-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESTER",
        "first_name": "BRENDA",
        "middle_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "H0107137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.