Individual provider Active NPI

Katrina Ann Roux-Bernstein, NP

  • Acute Care Nurse Practitioner
  • Glen Burnie, MD
National Provider Identifier
1710551494
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R189528 Issued in MD
Practice address
301 Hospital Dr
Glen Burnie, MD 21061-5803
Phone
(410) 787-4000
NPI assigned
May 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R189528 MD Primary
Critical Care Medicine Nurse Practitioner 363LC0200X R189528 MD

Addresses

Primary practice location

301 Hospital Dr
Glen Burnie, MD 21061-5803

Mailing address

1242 Morgan Station Rd
Woodbine, MD 21797-8724
Phone (013) 256-4187

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
I20210730000813 MD Practitioner - Nurse Practitioner 3476956293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

305 Hospital Dr
Suite 305
Glen Burnie, MD 21061-5862
Phone (410) 553-8240

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R189528MDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. CurrentSince Aug 1, 2021 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Aug 1, 2021 Accepting new patients

Locations

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

219 S Washington St
Easton, MD 21601

300 Hospital Dr
Ste 119
Glen Burnie, MD 21061
Phone (410) 553-8240

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

305 Hospital Dr
Ste 305
Glen Burnie, MD 21061
Phone (410) 553-8240

255 Hospital Dr
Fl 3
Glen Burnie, MD 21061
Phone (410) 553-8240

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

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.

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": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1710551494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1242 MORGAN STATION RD",
            "city": "WOODBINE",
            "state": "MD",
            "postal_code": "217978724",
            "telephone_number": "013-256-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615803",
            "telephone_number": "410-787-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUX-BERNSTEIN",
        "first_name": "KATRINA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R189528",
            "primary": true
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "MD",
            "license": "R189528",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.