Thomas J Krisanda, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

D0053345 Issued in MD

Practice address

5401 Old Court Road
Northwest Hospital Emergency Dept.
Randallstown, MD 21133

Phone

(410) 521-5950

Fax

(410) 828-6004

NPI assigned

Dec 26, 2006

Last updated

Apr 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MD, PA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Halethorpe, MD
  • NPI 1043378656
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Lutherville-Timonium Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Timonium, MD
  • NPI 1457023616
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba So. Baltimore County ASC

  • Ambulatory Surgical Clinic/Center
  • Halethorpe, MD
  • NPI 1942546486
  Medicare reassignment NPD
• Mep Health, LLC

  • Emergency Medicine Physician
  • Rockville, MD
  • NPI 1164483558
  Medicare reassignment NPD
• Mep Observation Services LLC

  • Emergency Medicine Physician
  • Cumberland, MD
  • NPI 1093003550
  Medicare reassignment NPD
• DLP Conemaugh Physician Practices LLC

  dba Conemaugh Physician Group Cresson

  • Family Medicine Physician
  • Cresson, PA
  • NPI 1932515905
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Shady Grove Peritoneal Dialysis Facility

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Mep Observation Services LLC

  • Internal Medicine Physician
  • Rockville, MD
  • NPI 1740021625
  NPD
• DLP Conemaugh Physician Practices LLC

  • Internal Medicine Physician
  • Johnstown, PA
  • NPI 1205242609
  NPD
• DLP Conemaugh Physician Practices LLC

  dba Cresson Family Practice

  • Rural Health Clinic/Center
  • Cresson, PA
  • NPI 1740696194
  NPD
• Penn State Health Medical Group, LLC

  • Dermatology Physician
  • Camp Hill, PA
  • NPI 1407500143
  NPD
• Penn State Health Medical Group, LLC

  • Diagnostic Radiology Physician
  • Harrisburg, PA
  • NPI 1457824013
  NPD

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1770648370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT ROAD",
            "address_2": "NORTHWEST HOSPITAL EMERGENCY DEPT.",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "21133",
            "telephone_number": "410-521-5950",
            "fax_number": "410-828-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT ROAD",
            "address_2": "NORTHWEST HOSPITAL EMERGENCY DEPT.",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "21133",
            "telephone_number": "410-521-5950",
            "fax_number": "410-828-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISANDA",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD043477E",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD-043477-E",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0053345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "246601500",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MED",
            "identifier": "930078599",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "75859901",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5401 Old Court Road",
            "address_2": "Northwest Hospital Emergency Dept.",
            "city": "Randallstown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "21133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Terris King Andre King
• Kingston C. Holcomb, Certified Counseling Associates, Inc.
• Rachel Kirkpatrick, PA-C
• Ibiyinka Morayo Kolawole
• Temiloluwa Kolawole, LCSW-C
• Ella I Krupitskaya, CRNP
• Aireen Kate Matute Kuan, M.D.
• Nisha G. Kurian, CRNA
• Varughese Kuruvilla, M.D.
• Anna Kvech-Hughes

• Emergency Medicine Physician in Randallstown, MD
• Providers in Randallstown, MD by specialty
• Emergency Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.