Active NPI
Berny J Kreutz, MD
- Surgery Physician
- Bethesda, MD
National Provider Identifier
1629073549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- D0012566
- Practice address
- 6420 Rockledge Dr
2200
Bethesda, MD 20817-7837 - Phone
- (301) 896-6880
- Fax
- (301) 896-6868
- NPI assigned
- Jun 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | D0012566 | MD | Primary |
Addresses
Primary practice location
6420 Rockledge Dr
2200
Bethesda, MD 20817-7837
Mailing address
PO Box 791372
Baltimore, MD 21279
Phone (301) 608-8375
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30056 | Other | MDIPA | |
| 415096100 | Medicaid | MD | |
| 5062BJ | Other | BC/BS | |
| 212221900 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0012566 | MD | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Premier Physician Group, LLC | Surgery | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Surgery Physician
- Bethesda, MD
- NPI 1801064704
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354579200000",
"number": "1629073549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 791372",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21279",
"telephone_number": "301-608-8375",
"fax_number": "301-608-3979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6420 ROCKLEDGE DR",
"address_2": "2200",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208177837",
"telephone_number": "301-896-6880",
"fax_number": "301-896-6868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KREUTZ",
"first_name": "BERNY",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2012-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MD",
"license": "D0012566",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDIPA",
"identifier": "30056",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "415096100",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "5062BJ",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "212221900",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.