Individual provider Active NPI

Sophie Korzan

  • Pulmonary Disease Physician
  • Baltimore, MD
National Provider Identifier
1124413844
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
D95147 Issued in MD
Practice address
3407 Wilkens Ave Ste 440
Baltimore, MD 21229-5073
Phone
(410) 644-3890
Fax
(410) 644-6517
NPI assigned
Mar 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 061359 CT
Pulmonary Disease Physician 207RP1001X D95147 MD Primary

Addresses

Primary practice location

3407 Wilkens Ave Ste 440
Baltimore, MD 21229-5073

Mailing address

3407 Wilkens Ave Ste 440
Baltimore, MD 21229-5073
Phone (410) 644-3890

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
I20220902001182 MD Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 8628380896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Agnes Healthcare IncGroup PAC ID 9830092733, 265 clinicians

Practice addresses (Care Compare)

3407 Wilkens Ave
440 The Lung Center
Baltimore, MD 21229-5073
Phone (410) 644-3890

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
061359CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Agnes Healthcare Inc Internal Medicine CurrentSince Sep 1, 2022 Accepting new patients
St Agnes Healthcare Inc CurrentSince Sep 1, 2022 Accepting new patients

Locations

3407 Wilkens Ave
Ste 440
Baltimore, MD 21229
Phone (410) 644-3890

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

700 Geipe Rd
Ste 200
Catonsville, MD 21228
Phone (410) 292-0038

Organizations & group practices 2

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": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1124413844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3407 WILKENS AVE STE 440",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295073",
            "telephone_number": "410-644-3890",
            "fax_number": "410-644-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 WILKENS AVE STE 440",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295073",
            "telephone_number": "410-644-3890",
            "fax_number": "410-644-6517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORZAN",
        "first_name": "SOPHIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "061359",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MD",
            "license": "D95147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.