Individual provider Active NPI

Boris Kerzner, M.D.

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1164598330
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0019317 Issued in MD
Practice address
111 Hamlet
Unit 1408
Baltimore, MD 21210
Phone
(443) 271-4549
Fax
(877) 991-4810
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0019317 MD Primary

Addresses

Primary practice location

111 Hamlet
Unit 1408
Baltimore, MD 21210

Mailing address

111 Hamlet Hill Rd Unit 1408
Baltimore, MD 21210-1518
Phone (443) 271-4549

Other identifiers 3

IdentifierTypeStateIssuer
KS30OtherMDCAREFIRST
T-754OtherMDFEDERAL BLUE CROSS
35880170MedicaidMD

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
I20240506001432 MD Order and Referring Only - Hospice/Palliative CarePractitioner - Hospice/Palliative Care 4385643139

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 1

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1164598330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HAMLET HILL RD UNIT 1408",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212101518",
            "telephone_number": "443-271-4549",
            "fax_number": "877-991-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HAMLET",
            "address_2": "UNIT 1408",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21210",
            "telephone_number": "443-271-4549",
            "fax_number": "877-991-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERZNER",
        "first_name": "BORIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2024-05-06",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0019317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "KS30",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLUE CROSS",
            "identifier": "T-754",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35880170",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.