Individual provider Active NPI

Iryne Zziwa-Kabenge, CRNP

  • Adult Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1124277249
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R133308 Issued in MD
Practice address
1830 E Monument St
Suite 418
Baltimore, MD 21287-0020
Phone
(410) 614-1069
Fax
(410) 955-7889
NPI assigned
Sep 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R133308 MD Primary

Addresses

Primary practice location

1830 E Monument St
Suite 418
Baltimore, MD 21287-0020

Mailing address

4404 Wynfield Dr
Owings Mills, MD 21117-7141
Phone (443) 522-0383

Other identifiers 1

IdentifierTypeStateIssuer
049292200MedicaidMD

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111220000365 MD Practitioner - Nurse Practitioner 9739355843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

1046 Taylor Ave
Towson, MD 21286-8312
Phone (410) 887-2437

5601 Lloch Raven Blvd
Baltimore, MD 21239-2945
Phone (443) 444-4714

600 N Wolf St
Baltimore, MD 21287-0005
Phone (410) 955-5000

600 N Wolfe St
Blalock 266
Baltimore, MD 21287-0005
Phone (410) 502-4340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Dec 1, 2011 Accepting new patients
Johns Hopkins University CurrentSince Dec 1, 2011 Accepting new patients
Johns Hopkins University Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

Interoperability endpoints

  • Direct secure messaging: izziwakabenge34143@direct.hopkinsmedicine.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1124277249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4404 WYNFIELD DR",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211177141",
            "telephone_number": "443-522-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 E MONUMENT ST",
            "address_2": "SUITE 418",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870020",
            "telephone_number": "410-614-1069",
            "fax_number": "410-955-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZZIWA-KABENGE",
        "first_name": "IRYNE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-12",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R133308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049292200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.