Active NPI
Robert Krenzer, MD
- Neurology Physician
- Palm Bay, FL
National Provider Identifier
1215910047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- ME88699
- Practice address
- 1425 Malabar Rd NE
Palm Bay, FL 32907-2506 - Phone
- (321) 434-8078
- NPI assigned
- Nov 25, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | ME88699 | FL | |
| Neurology Physician | 2084N0400X | ME88699 | FL | Primary |
Addresses
Primary practice location
1425 Malabar Rd NE
Palm Bay, FL 32907-2506
Mailing address
3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 434-8078
Other practice location 1
775 Malabar Rd
Malabar, FL 32950-3112
Phone (321) 241-6800
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 81678 | Other | FL | BLUE CROSS BLUE SHIELD |
| 014198900 | Medicaid | FL | |
| 5943218 | Other | FL | AETNA |
| 81678X | Other | FL | MEDICARE |
| 3365222 | Other | FL | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME88699 | FL | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omnihealthcare Inc | Past | Accepting new patients | |
| Omni Healthcare, Inc | Past | Accepting new patients | |
| Vero Orthopaedics II PA | Neurology | Past | Accepting new patients |
| Omni Healthcare, Inc. | Past | Accepting new patients | |
| Vero Orthopaedics II PA | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 5
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.
-
- Diagnostic Radiology Physician
- Melbourne, FL
- NPI 1053382457
-
- Clinical Medical Laboratory
- Melbourne, FL
- NPI 1598736985
-
- General Practice Physician
- Melbourne, FL
- NPI 1134371933
-
- Neuromusculoskeletal Medicine & OMM Physician
- Vero Beach, FL
- NPI 1184626079
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709510400000",
"number": "1215910047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 S FISKE BLVD",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329554306",
"telephone_number": "321-434-8078",
"fax_number": "321-951-7408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 MALABAR RD NE",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329072506",
"telephone_number": "321-434-8078"
}
],
"practiceLocations": [
{
"address_1": "775 Malabar Rd",
"address_purpose": "LOCATION",
"city": "Malabar",
"state": "FL",
"postal_code": "329503112",
"country_code": "US",
"telephone_number": "321-241-6800",
"fax_number": "321-241-6890",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KRENZER",
"first_name": "ROBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-25",
"last_updated": "2024-03-04",
"certification_date": "2024-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "FL",
"license": "ME88699",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "FL",
"license": "ME88699",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "81678",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "014198900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5943218",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "81678X",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3365222",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.