Individual provider Active NPI

Gregory Stanleon Pokrywka, M.D. FACP

  • Internal Medicine Physician
  • Kensington, MD
National Provider Identifier
1417082322
Registry record updated Mar 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0032939 Issued in MD
Practice address
5268 Nicholson LN
Suite S
Kensington, MD 20895-1009
Phone
(301) 231-5055
Fax
(301) 231-7217
NPI assigned
Feb 22, 2007
Last updated
Mar 23, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0032939 MD Primary

Addresses

Primary practice location

5268 Nicholson LN
Suite S
Kensington, MD 20895-1009

Mailing address

5268 Nicholson LN
Suite S
Kensington, MD 20895-1009
Phone (301) 231-5055

Other identifiers 1

IdentifierTypeStateIssuer
399261660MedicaidMD

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050720001003 MD Practitioner - Internal Medicine 1557398690 Practice locations: Towson, MD

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Maryland School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7801 York Rd
Suite 300
Towson, MD 21204-7449
Phone (410) 337-0720

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0032939MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baltimore Lipid Center Internal Medicine PastSince Jan 1, 1990 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Better Health Medical Center Internal Medicine PastSince Oct 3, 2012 Accepting new patients

Organizations & group practices 3

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395532800000",
    "number": "1417082322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5268 NICHOLSON LN",
            "address_2": "SUITE S",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208951009",
            "telephone_number": "301-231-5055",
            "fax_number": "301-231-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5268 NICHOLSON LN",
            "address_2": "SUITE S",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208951009",
            "telephone_number": "301-231-5055",
            "fax_number": "301-231-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POKRYWKA",
        "first_name": "GREGORY",
        "middle_name": "STANLEON",
        "credential": "M.D. FACP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2014-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0032939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "399261660",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kensington, MD

Sources for this page

Verify at the official NPI Registry.