Individual provider Active NPI

Kristen Boblooch Rose

  • Adult Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1124446414
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R194465 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-9503
NPI assigned
Apr 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

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 R194465 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

22 S Greene St
Baltimore, MD 21201-1544
Phone (410) 328-9503

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
I20141002001463 MD Practitioner - Nurse Practitioner 6507086105 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Maryland Oncology Associates PAGroup PAC ID 0446156483, 61 clinicians

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-1230

Hospital & facility affiliations

  • University of Maryland Medical Center Hospital, Baltimore, MD, CCN 210002

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Nov 23, 2020 Accepting new patients
University of Maryland Emergency Medicine Associates, PA CurrentSince Aug 5, 2014 Accepting new patients
Upper Chesapeake Emergency Medicine Physicians, LLC CurrentSince Dec 1, 2021 Accepting new patients
University of Maryland Oncology Associates, PA CurrentSince Aug 18, 2021 Accepting new patients
University of Maryland Midtown Health Inc CurrentSince Nov 27, 2016 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince May 15, 2024 Accepting new patients
University of Maryland Orthopaedic Associates P a CurrentSince Apr 17, 2018 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Nov 23, 2020 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince May 15, 2024 Accepting new patients
University of Maryland Oncology Associates, PA CurrentSince Aug 18, 2021 Accepting new patients
University of Maryland Orthopaedic Associates PA CurrentSince Apr 17, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

660 McHenry Rd
Aberdeen, MD 21001
Phone (443) 643-1500

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

821 N Eutaw St
Baltimore, MD 21201
Phone (410) 225-9185

105 Penn St
Baltimore, MD 21201
Phone (410) 328-2387

22 S Greene St
#N6W40
Baltimore, MD 21201

520 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (410) 836-0128

100 Hospital Rd
Prnc Frederck, MD 20678
Phone (410) 414-4791

1 Texas Station Ct
Timonium, MD 21093
Phone (410) 683-2120

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

Interoperability endpoints

  • Direct secure messaging: kboblooch105464@direct.umm.edu

Organizations & group practices 12

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": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507593600000",
    "number": "1124446414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KRISTEN",
        "middle_name": "BOBLOOCH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2017-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R194465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.