Individual provider Active NPI

Jennifer Krizman

  • Acute Care Nurse Practitioner
  • Clarksburg, MD
National Provider Identifier
1740053685
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
NP500015242 Issued in DC
Practice address
22782 Autumn Breeze Ave
Clarksburg, MD 20871-5355
Phone
(216) 906-9141
NPI assigned
Nov 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X NP500015242 DC Primary

Addresses

Primary practice location

22782 Autumn Breeze Ave
Clarksburg, MD 20871-5355

Mailing address

22782 Autumn Breeze Ave
Clarksburg, MD 20871-5355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20240228000636 DC Practitioner - Nurse Practitioner 0648615872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johns Hopkins Community Physicians, IncGroup PAC ID 8325943707, 764 clinicians

Practice addresses (Care Compare)

14207 Park Ctr Dr
Suite 102
Laurel, MD 20707-5255
Phone (301) 604-5254

5255 Loughboro Rd NW
Washington, DC 20016-2633
Phone (202) 537-4000

Hospital & facility affiliations

  • Sibley Memorial Hospital Hospital, Washington, DC, CCN 090005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP500015242DCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians, Inc CurrentSince Jan 16, 2024 Accepting new patients
Johns Hopkins Community Physicians CurrentSince Jan 16, 2024 Accepting new patients

Locations

14207 Park Center Dr
Ste 102
Laurel, MD 20707
Phone (301) 604-5254

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: jkrizman399841@direct.hopkinsmedicine.org

Organizations & group practices 3

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": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1740053685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22782 AUTUMN BREEZE AVE",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208715355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22782 AUTUMN BREEZE AVE",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208715355",
            "telephone_number": "216-906-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIZMAN",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "DC",
            "license": "NP500015242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksburg, MD

Sources for this page

Verify at the official NPI Registry.