Individual provider Active NPI

Kendyl Kradz

  • Clinical Social Worker
  • Bethesda, MD
National Provider Identifier
1376154344
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22108 Issued in MD
Practice address
4401 E West Hwy
Bethesda, MD 20814-4523
Phone
(215) 760-8688
NPI assigned
Aug 13, 2020
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22108 MD Primary

Addresses

Primary practice location

4401 E West Hwy
Bethesda, MD 20814-4523

Mailing address

960 Florida Ave NW
Washington, DC 20001-4046
Phone (215) 760-8688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200908003369 DC Practitioner - Clinical Social Worker 2466870423 Reassigns benefits to 1 organization
I20240216004080 MD Practitioner - Clinical Social Worker 2466870423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychogeriatric Services LLCGroup PAC ID 6002719226, 122 clinicians

Practice addresses (Care Compare)

12073 Tech Rd
Suite B
Silver Spring, MD 20904-7874
Phone (301) 593-1315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychogeriatric Services LLC Clinical CurrentSince Dec 12, 2023 Accepting new patients

Locations

4101 Old National Pike
Mount Airy, MD 21771
Phone (301) 829-0800

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1376154344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 FLORIDA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200014046",
            "telephone_number": "215-760-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 E WEST HWY",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144523",
            "telephone_number": "215-760-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRADZ",
        "first_name": "KENDYL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "22108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.