Individual provider Active NPI

Kenneth John Taubenslag, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Baltimore, MD
National Provider Identifier
1538554266
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
D0091402 Issued in MD
Practice address
419 W Redwood St Ste 470
Baltimore, MD 21201-7009
Phone
(667) 214-1111
Fax
(410) 328-6503
NPI assigned
Mar 31, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D0091402 MD
Retina Specialist (Ophthalmology) Physician 207WX0107X D0091402 MD Primary

Addresses

Primary practice location

419 W Redwood St Ste 470
Baltimore, MD 21201-7009

Mailing address

419 W Redwood St Ste 470
Baltimore, MD 21201-7009
Phone (667) 214-1111

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
I20210719000110 MD Practitioner - Ophthalmology 3577899921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Vanderbilt University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

419 W Redwood St
Suite 420
Baltimore, MD 21201-7002
Phone (667) 214-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58992TNMDRegistered Nurse
D0091402MDMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Eye Associates, P.a. Ophthalmology CurrentSince Sep 1, 2021 Accepting new patients
University of Maryland Eye Associates, P.a. CurrentSince Sep 1, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

419 W Redwood St
Ste 470
Baltimore, MD 21201
Phone (667) 214-1197

419 W Redwood St
Ste 420
Baltimore, MD 21201
Phone (410) 328-6533

Interoperability endpoints

  • Direct secure messaging: ktaubenslag837635@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 and National Provider Directory roles.

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": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1538554266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 W REDWOOD ST STE 470",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212017009",
            "telephone_number": "667-214-1111",
            "fax_number": "410-328-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 W REDWOOD ST STE 470",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212017009",
            "telephone_number": "667-214-1111",
            "fax_number": "410-328-6503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUBENSLAG",
        "first_name": "KENNETH",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-31",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0091402",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MD",
            "license": "D0091402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.