Kenneth Tellerman, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D0025147 Issued in MD

Practice address

711 W 40TH St Ste 438
Baltimore, MD 21211-2199

Phone

(410) 243-8632

Fax

(410) 243-0470

NPI assigned

Oct 3, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ktellerman136566@direct.umm.edu

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.

• Family Time Pediatrics, LLC

  • Pediatrics Physician
  • Baltimore, MD
  • NPI 1770291692
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1215924402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 KEN OAK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094310",
            "telephone_number": "410-664-6632",
            "fax_number": "410-243-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W 40TH ST STE 438",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112199",
            "telephone_number": "410-243-8632",
            "fax_number": "410-243-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLERMAN",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0025147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "350701700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mayan Teles
• Anna Jane Capp Telewicz, CRNP
• Emily Jane Telfair Hadley, N.D.
• Christiane Tellefsen, M.D.
• Tellerman & Associates, LLC
• Yenly Carolina Tellez Lopez, LGPC
• Beverly Jean Tellis, MSW LCSW-C
• Jessica Tellis, MS-CCC SLP
• Rebecca Helene Tello
• Shinyi Telscher, PHARMD

• Pediatrics Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.