Leo Israel Korotki, M.D.

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

D0024017 Issued in MD

Practice address

1205 York Rd
Suite 22
Lutherville, MD 21093-6210

Phone

(410) 823-9333

Fax

(410) 823-9335

NPI assigned

Jun 30, 2005

Reactivated

Mar 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Effective Integrative Healthcare, LLC

  • Physical Medicine & Rehabilitation Physician
  • Millersville, MD
  • NPI 1568707081

  MD

  Medicare reassignment NPD
• Five Star Physician Services, LLC

  • Internal Medicine Physician
  • Linthicum Heights, MD
  • NPI 1083654479

  MD

  Medicare reassignment
• Leo I. Korotki, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Baltimore, MD
  • NPI 1053371617
  NPD (past) Authorized official
• Fidel Chiropractic Center, Inc.

  • Rehabilitation Chiropractor
  • Baltimore, MD
  • NPI 1134345101
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1710984232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 YORK RD",
            "address_2": "SUITE 22",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936210",
            "telephone_number": "410-823-9333",
            "fax_number": "410-823-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 YORK RD",
            "address_2": "SUITE 22",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936210",
            "telephone_number": "410-823-9333",
            "fax_number": "410-823-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROTKI",
        "first_name": "LEO",
        "middle_name": "ISRAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2016-02-17",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MD",
            "license": "D0024017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI/ALLIANCE",
            "identifier": "218835",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE/BC/BS FEDERAL",
            "identifier": "S042",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "5037",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward M Klepper II, PA-C
• Edward J Klopp, LCPC
• Talya Knable, LCPC
• Ilan Kokotek, DO
• Martin Bruce Koretzky, PH.D.
• Jerome Kowalewski, PHD
• Ibikunle Olayemi Koya, MD
• Walter Ernest Kozachuk, M.D.
• Elizabeth R Kramer, M.AC., L.AC.
• Fadi Kreisheh, DMD

• All providers in Lutherville, MD
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.