Individual provider Active NPI

Bruce C Kinzinger, MD

  • Family Medicine Physician
  • Aberdeen, MD
National Provider Identifier
1174552012
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0044260 Issued in MD
Practice address
995 Hospitality Way
Aberdeen, MD 21001-1755
Phone
(410) 306-7880
Fax
(410) 306-7881
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD418799 PA
Family Medicine Physician 207Q00000X D0044260 MD Primary

Addresses

Primary practice location

995 Hospitality Way
Aberdeen, MD 21001-1755

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700

Other identifiers 1

IdentifierTypeStateIssuer
001890267MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MDExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110329000713 MD Practitioner - Family Practice 2961432752 Reassigns benefits to 1 organization
I20140502001443 DC Practitioner - Family Practice 2961432752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kentucky College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patient First Maryland Medical Group PLLCGroup PAC ID 4385538735, 258 clinicians
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians

Practice addresses (Care Compare)

10210 Reisterstown Rd
Owings Mills, MD 21117-3606
Phone (410) 902-6776

12 Newport Dr
Forest Hill, MD 21050-1758

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD418799PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Maryland Medical Group, PLLC Family Medicine Current Accepting new patients
Patient First Maryland Medical Group PLLC Family Medicine CurrentSince Dec 24, 2013 Accepting new patients
Patient First Maryland Medical Group PLLC Family Medicine CurrentSince Jan 18, 2011 Accepting new patients
Patient First Maryland Medical Group PLLC Family Medicine CurrentSince Jan 18, 2011 Accepting new patients
Helixcare Medical Group, LLC Past Accepting new patients
Franklin Square Hospital Center, Inc. Past Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

995 Hospitality Way
Aberdeen, MD 21001
Phone (410) 306-7880

10210 Reisterstown Rd
Owings Mills, MD 21117
Phone (410) 902-6776

10210 Reisterstown Rd
#12302
Owings Mills, MD 21117
Phone (410) 902-6776

726 Rockville Pike
Rockville, MD 20852
Phone (240) 238-0411

2855 Crain Hwy
Waldorf, MD 20601
Phone (240) 427-1926

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

Interoperability endpoints

  • Direct secure messaging: mdexchange@patientfirstclinics.com

Organizations & group practices 8

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1174552012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 HOSPITALITY WAY",
            "city": "ABERDEEN",
            "state": "MD",
            "postal_code": "210011755",
            "telephone_number": "410-306-7880",
            "fax_number": "410-306-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINZINGER",
        "first_name": "BRUCE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD418799",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0044260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001890267",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MDExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "995 Hospitality Way",
            "city": "Aberdeen",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210011755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aberdeen, MD

Sources for this page

Verify at the official NPI Registry.