Individual provider Active NPI

Jonathan Bromberg, MD

  • Transplant Surgery Physician
  • Baltimore, MD
National Provider Identifier
1497721294
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transplant Surgery PhysicianTaxonomy code 204F00000X
License
D71017 Issued in MD
Practice address
16 S Eutaw St FL 1
Baltimore, MD 21201-1606
Phone
(410) 328-5408
NPI assigned
Feb 23, 2006
Last updated
Feb 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 213609 NY
Transplant Surgery Physician 204F00000X D71017 MD Primary
Transplant Surgery Physician 204F00000X 213609 NY

Addresses

Primary practice location

16 S Eutaw St FL 1
Baltimore, MD 21201-1606

Mailing address

PO Box 64226
Baltimore, MD 21264-4226
Phone (410) 328-0008

Other identifiers 1

IdentifierTypeStateIssuer
02094439MedicaidNY

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
I20110110000513 MD Practitioner - General Surgery 9335237874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Harvard Medical School, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-5191

29 S Greene St
Suite 319
Baltimore, MD 21201-1544

419 W Redwood St
FL 3
Baltimore, MD 21201-1734
Phone (410) 328-5300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
213609NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Surgical Associates, PA CurrentSince Oct 1, 2010 Accepting new patients
University of Maryland Surgcial Assoc PA Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

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

419 W Redwood St
Fl 3
Baltimore, MD 21201
Phone (410) 328-5300

Interoperability endpoints

  • Direct secure messaging: jbromberg18992@direct.umm.edu

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.

Hospital & facility affiliations 2

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1497721294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64226",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644226",
            "telephone_number": "410-328-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 S EUTAW ST FL 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011606",
            "telephone_number": "410-328-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMBERG",
        "first_name": "JONATHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "213609",
            "primary": false
        },
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "MD",
            "license": "D71017",
            "primary": true
        },
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "NY",
            "license": "213609",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02094439",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.