Kerwin Borntrager, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0004929 Issued in MD

Practice address

1313 Forest Hill Ave
Baltimore, MD 21230-1121

Phone

(443) 717-4334

NPI assigned

Nov 18, 2013

Last updated

Nov 18, 2013By the provider in NPPES

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Agnes Healthcare IncGroup PAC ID 9830092733, 265 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Agnes Hospital Hospital, Baltimore, MD, CCN 210011

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Agnes Healthcare Inc

  dba Integrated Specialists Group

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1144250176

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Northwest Hospital Center, Inc

  dba NW Breast Care Ctr,Hospitalist,PA, SHS Plastics,Surgical House Staff

  • Hospitalist Physician
  • Randallstown, MD
  • NPI 1508961988

  Physician Assistant

  Medicare reassignment NPD
• Sage Hollow Health PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Shelton, CT
  • NPI 1003700071

  MD

  Medicare reassignment NPD
• Post Acute Physician Partners, LLC

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1710385554
  Medicare reassignment
• Northwest Hospital Center, Inc.

  dba Chronic Disease Clinic

  • Acute Care Nurse Practitioner
  • Randallstown, MD
  • NPI 1235669599
  NPD
• St Agnes Healthcare Inc

  • Diagnostic Radiology Physician
  • Baltimore, MD
  • NPI 1780615922
  NPD
• Saunders & Peavy LLC

  dba Emergicare of Harrisonburg

  • Urgent Care Clinic/Center
  • Harrisonburg, VA
  • NPI 1245908268
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Agnes Healthcare, Inc.

  dba St.Agnes Hospital

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1245274901
  Care Compare affiliation

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384732800000",
    "number": "1265862890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 FOREST HILL AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212301121",
            "telephone_number": "443-717-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 FOREST HILL AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212301121",
            "telephone_number": "443-717-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORNTRAGER",
        "first_name": "KERWIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-18",
        "last_updated": "2013-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0004929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Borm
• Louis Born, MD, PHD
• Linda S Borneman, RN, ACNP
• Julia Borniva, M.D.
• Charles Bornmann
• Helen V Boro, DC
• Marina Borodkina, MD
• Agnieszka Boron, MD
• John J Boronow, MD
• Shoshanna Boroosan, LMSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.