Individual provider Active NPI

Alan Bruce Kravitz, M.D.

  • Surgery Physician
  • Rockville, MD
National Provider Identifier
1295825206
Registry record updated Mar 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D37295 Issued in MD
Practice address
11119 Rockville Pike
Suite 105
Rockville, MD 20852-3143
Phone
(301) 493-9400
Fax
(301) 493-9412
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X D37295 MD Primary

Addresses

Primary practice location

11119 Rockville Pike
Suite 105
Rockville, MD 20852-3143

Mailing address

11119 Rockville Pike
Suite 105
Rockville, MD 20852-3143
Phone (301) 493-9400

Other identifiers 3

IdentifierTypeStateIssuer
295241600MedicaidMD
C14034OtherMDRAILROAD GRP#
010026389OtherMDRAILROAD #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20111220000712 DC Practitioner - General Surgery 5890982334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Maryland School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11119 Rockville Pike
Suite 105
Rockville, MD 20852-3143
Phone (301) 493-9400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)42
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D37295MDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alan B Kravitz M.D., P.a Surgery CurrentSince Oct 17, 1988 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

11119 Rockville Pike
Ste 105
Rockville, MD 20852
Phone (240) 691-4377

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237161600000",
    "number": "1295825206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11119 ROCKVILLE PIKE",
            "address_2": "SUITE 105",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523143",
            "telephone_number": "301-493-9400",
            "fax_number": "301-493-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11119 ROCKVILLE PIKE",
            "address_2": "SUITE 105",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523143",
            "telephone_number": "301-493-9400",
            "fax_number": "301-493-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAVITZ",
        "first_name": "ALAN",
        "middle_name": "BRUCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2009-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D37295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295241600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GRP#",
            "identifier": "C14034",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD #",
            "identifier": "010026389",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.