Individual provider Active NPI

Kjell J Wiberg, MD

  • Infectious Disease Physician
  • Baltimore, MD
National Provider Identifier
1801939434
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
D0071592 Issued in MD
Practice address
2435 W Belvedere Ave
Suite 17
Baltimore, MD 21215-5224
Phone
(410) 601-6207
Fax
(410) 601-6006
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X D0071592 MD Primary
Infectious Disease Physician 207RI0200X MD038943 DC

Addresses

Primary practice location

2435 W Belvedere Ave
Suite 17
Baltimore, MD 21215-5224

Mailing address

2401 W Belvedere Ave
Attn: Infectious Disease
Baltimore, MD 21215-5216
Phone (410) 601-6207

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111004000243 MD Practitioner - Infectious DiseasePractitioner - Internal Medicine 1456523075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Group practices
Sinai Hospital of Baltimore, IncGroup PAC ID 0941112346, 373 clinicians

Practice addresses (Care Compare)

849 Fairmount Ave
Suite 100B
Towson, MD 21286-2600
Phone (410) 469-4981

Hospital & facility affiliations

  • Homecare Maryland, LLC Home health agency, Owings Mills, MD, CCN 217107
  • Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD038943DCMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc Infectious Disease CurrentSince Aug 14, 2015 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Aug 14, 2015 Accepting new patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Sinai Hospital of Baltimore Inc Infectious Disease Past Accepting new patients

Locations

2435 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 601-0900

2401 W Belvedere Ave
Baltimore, MD 21215

2435 W Belvedere Ave
Ste 17
Baltimore, MD 21215
Phone (410) 601-5941

849 Fairmount Ave
Ste 100B
Towson, MD 21286
Phone (410) 235-1168

Organizations & group practices 5

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 3

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1801939434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "address_2": "ATTN: INFECTIOUS DISEASE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-6207",
            "fax_number": "410-601-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 W BELVEDERE AVE",
            "address_2": "SUITE 17",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155224",
            "telephone_number": "410-601-6207",
            "fax_number": "410-601-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIBERG",
        "first_name": "KJELL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MD",
            "license": "D0071592",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "DC",
            "license": "MD038943",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.