Individual provider Active NPI

Leonard Anatoly Kazanov, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Frederick, MD
National Provider Identifier
1124026323
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
D0053809 Issued in MD
Practice address
5930 Frederick Crossing LN
Frederick, MD 21704-5137
Phone
(240) 379-7776
Fax
(240) 379-7787
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X D0053809 MD Primary

Addresses

Primary practice location

5930 Frederick Crossing LN
Frederick, MD 21704-5137

Mailing address

5930 Frederick Crossing LN
Frederick, MD 21704-5137
Phone (240) 379-7776

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
I20110518000657 MD Practitioner - Emergency Medicine 7618991381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Maryland School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monocacy Emergency Physicians PCGroup PAC ID 6800810573, 7 clinicians

Practice addresses (Care Compare)

5930 Frederick Crossing LN
Suite 101
Frederick, MD 21704-5149
Phone (240) 379-7776

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Monocacy Emergency Physicians PC CurrentSince Aug 1, 2002 Accepting new patients
Washington County Emergency Medicine Physicians, LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5930 Frederick Crossing Ln
Frederick, MD 21704
Phone (240) 379-7776

5930 Frederick Crossing Ln
Ste 101
Frederick, MD 21704
Phone (240) 379-7776

Interoperability endpoints

  • Direct secure messaging: leonardkazanov@wcucf.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1124026323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5930 FREDERICK CROSSING LN",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217045137",
            "telephone_number": "240-379-7776",
            "fax_number": "240-379-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5930 FREDERICK CROSSING LN",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217045137",
            "telephone_number": "240-379-7776",
            "fax_number": "240-379-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZANOV",
        "first_name": "LEONARD",
        "middle_name": "ANATOLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MD",
            "license": "D0053809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.