Individual provider Active NPI

Robert Krenzer, MD

  • Neurology Physician
  • Palm Bay, FL
National Provider Identifier
1215910047
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME88699 Issued in FL
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

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
81678OtherFLBLUE CROSS BLUE SHIELD
014198900MedicaidFL
5943218OtherFLAETNA
81678XOtherFLMEDICARE
3365222OtherFLAETNA

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

LicenseStateTypeSpecialty
ME88699FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Omnihealthcare Inc PastSince Jan 1, 1990 Accepting new patients
Omni Healthcare, Inc PastSince Jan 1, 1990 Accepting new patients
Vero Orthopaedics II PA Neurology PastSince Aug 28, 2021 Accepting new patients
Omni Healthcare, Inc. PastSince Jan 1, 1990 Accepting new patients
Vero Orthopaedics II PA PastSince Jul 1, 1997 Accepting new patients

Interoperability endpoints

  • FHIR API: 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.

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.

Verify at the official NPI Registry.