Individual provider Active NPI

Derek D Kaznoski, M.D.

  • Gynecology Physician
  • Martinsburg, WV
National Provider Identifier
1689675027
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
23323 Issued in WV
Practice address
1178 Shepherdstown Rd
Martinsburg, WV 25404-0500
Phone
(304) 264-9332
NPI assigned
Aug 9, 2005
Last updated
Feb 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 23323 WV Primary

Addresses

Primary practice location

1178 Shepherdstown Rd
Martinsburg, WV 25404-0500

Mailing address

1178 Shepherdstown Rd
Martinsburg, WV 25404-0500
Phone (304) 264-9332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20090604000356 WV Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 5890765721 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
West Virginia University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1178 Shepherdstown Rd
Martinsburg, WV 25404-0500
Phone (304) 264-9332

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
War Memorial Hospital, Inc. CurrentSince Oct 8, 2024 Accepting new patients
War Memorial Hospital Inc CurrentSince Oct 8, 2024 Accepting new patients
Woman and Child, PC Gynecology CurrentSince Mar 9, 2009 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1 Healthy Way
Berkeley Springs, WV 25411
Phone (304) 258-1234

1004 Tavern Rd
Martinsburg, WV 25401
Phone (304) 262-3000

1178 Shepherdstown Rd
Martinsburg, WV 25404
Phone (304) 264-9332

Organizations & group practices 4

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 5

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1689675027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1178 SHEPHERDSTOWN RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254040500",
            "telephone_number": "304-264-9332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1178 SHEPHERDSTOWN RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254040500",
            "telephone_number": "304-264-9332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZNOSKI",
        "first_name": "DEREK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "WV",
            "license": "23323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.