NPIMap

Individual provider Active NPI

Kenneth M Crandall, MD

  • Neurological Surgery Physician
  • Towson, MD
National Provider Identifier
1447485891
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
D0083337 Issued in MD
Practice address
7505 Osler Dr Ste 104
Towson, MD 21204-7737
Phone
(410) 337-8888
Fax
(410) 823-4833
NPI assigned
May 28, 2009
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X D0083337 MD Primary

Addresses

Primary practice location

7505 Osler Dr Ste 104
Towson, MD 21204-7737

Mailing address

8322 Bellona Ave Ste 100
Towson, MD 21204-2065
Phone (410) 337-7900

Other identifiers 1

IdentifierTypeStateIssuer
D0083337OtherMDMARYLAND LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170822000963 MD Practitioner - Neurosurgery 7719286848 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Miami, LM Miller School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Shock Trauma Associates PAGroup PAC ID 6800882317, 258 clinicians
University of Maryland Neurosurgery Associates P aGroup PAC ID 9133187750, 24 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

1305 S Salisbury Blvd
Suite 5
Salisbury, MD 21801-6845
Phone (667) 253-2323

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-6704

7505 Osler Dr
Towson, MD 21204-7740

7505 Osler Dr
Suite 305 307
Towson, MD 21204-7736
Phone (410) 337-4877

7601 Osler Dr
Towson, MD 21204-7700
Phone (410) 337-1379

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion262
Laminectomy or laminotomy (partial removal of spine bones)82
Melanoma (skin cancer) excision15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0083337MDMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Feb 1, 2021 Accepting new patients
University of Maryland Neurosurgery Associates P a Neurological Surgery CurrentSince Jul 24, 2017 Accepting new patients
Shock Trauma Associates, P.a. CurrentSince Jan 6, 2018 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Feb 1, 2021 Accepting new patients
University of Maryland St. Joseph Orthopaedics, LLC CurrentSince Jul 24, 2017 Accepting new patients
University of Maryland St. Joseph Orthopaedics, LLC CurrentSince Jul 24, 2017 Accepting new patients
University of Maryland Medical Center, LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

22 S Greene St
#S12D
Baltimore, MD 21201

22 S Greene St
Ste 12D
Baltimore, MD 21201
Phone (410) 328-6034

22 S Greene St
Ste S12D
Baltimore, MD 21201
Phone (410) 328-6034

351 W Camden St
Ste 501
Baltimore, MD 21201
Phone (410) 328-6034

7505 Osler Dr
Ste 104
Towson, MD 21204
Phone (410) 337-8888

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

8322 Bellona Ave
Towson, MD 21204
Phone (410) 328-3645

8322 Bellona Ave
Rm 100
Towson, MD 21204
Phone (410) 337-7900

Interoperability endpoints

  • Direct secure messaging: kcrandall6877@direct.umm.edu
  • Direct secure messaging: kennethcrandall@towsonorth.allscriptsdirect.net

Organizations & group practices 9

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 5

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": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1447485891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8322 BELLONA AVE STE 100",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042065",
            "telephone_number": "410-337-7900",
            "fax_number": "410-769-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7505 OSLER DR STE 104",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047737",
            "telephone_number": "410-337-8888",
            "fax_number": "410-823-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "KENNETH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MD",
            "license": "D0083337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND LICENSE",
            "identifier": "D0083337",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.