Ilya Rozenberg, MS/CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R143360 Issued in MD

Practice address

7452 Baltimore Annapolis Blvd
Suite 107
Glen Burnie, MD 21061-3547

Phone

(410) 766-1544

Fax

(410) 766-1551

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Holistic Approach Mental Health,LLCGroup PAC ID 3779711973, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

27.18 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

90.6

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

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 and National Provider Directory roles.

• Holistic Approach Mental Health, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Glen Burnie, MD
  • NPI 1528496650
  Medicare reassignment Care Compare group NPD Authorized official
• Baltimore Medical System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Baltimore, MD
  • NPI 1700882503
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1467460865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MARCIE WOODS CT",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212081965",
            "telephone_number": "410-766-1544",
            "fax_number": "410-766-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7452 BALTIMORE ANNAPOLIS BLVD",
            "address_2": "SUITE 107",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613547",
            "telephone_number": "410-766-1544",
            "fax_number": "410-766-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZENBERG",
        "first_name": "ILYA",
        "name_prefix": "Mr.",
        "credential": "MS/CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R143360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402464800",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "463350400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne Rouleau, AU.D.
• Katrina Ann Roux-Bernstein, NP
• Elizabeth Ann Rowe
• Nicole Alyssa Rowe, M.D.
• Debajit Roy, M.D.
• Cynthia Lucille Ruby, LCSW-C
• Cheryl Ann Ruddick, CRNP
• Rhonda Rudiger
• Kelly Ann Runfola, PT, MS
• Megan Ruoss, PA-C

• Psychiatric/Mental Health Nurse Practitioner in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.