Individual provider Active NPI

Michelle Lynne Krenzke, ATC, PA-C

  • Medical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1639718810
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0010010 Issued in MD
Practice address
5601 Loch Raven Blvd
Baltimore, MD 21239-2950
Phone
(301) 956-4821
NPI assigned
Jan 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X A0001118 MD
Medical Physician Assistant 363AM0700X C0010010 MD Primary

Addresses

Primary practice location

5601 Loch Raven Blvd
Baltimore, MD 21239-2950

Mailing address

5601 Loch Raven Blvd
Baltimore, MD 21239-2950
Phone (301) 956-4821

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250807000249 MD Practitioner - Physician Assistant 7719485036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440

5601 Lloch Raven Blvd
Baltimore, MD 21239-2945
Phone (410) 581-1200

5601 Loch Raven Blvd Russel
Ste2
Baltimore, MD 21239-2945
Phone (443) 444-5600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
A0001118MDMDAthletic Trainer
C0010010MDMDMedical Physician Assistant

Organizations & group practices 1

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 1

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": "1578182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1639718810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392950",
            "telephone_number": "301-956-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392950",
            "telephone_number": "301-956-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRENZKE",
        "first_name": "MICHELLE",
        "middle_name": "LYNNE",
        "name_prefix": "Miss",
        "credential": "ATC, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-05",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0001118",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0010010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.