Marc Lyle Kozam, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

D44289 Issued in MD

Practice address

18111 Prince Philip Dr
Suite T-14
Olney, MD 20832-1513

Phone

(301) 774-4400

Fax

(301) 774-1034

NPI assigned

Dec 20, 2005

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 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Gastroenterology

Education

University of Alabama School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medstar Montgomery Medical Center Hospital, Olney, MD, CCN 210018

Merit-based Incentive Payment System (MIPS)

Final score

22.07 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

73.58

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Montgomery General Hospital, Inc.

  • General Acute Care Hospital
  • Olney, MD
  • NPI 1114922341

  Corporate Director

  CMS ownership

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.

• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187

  DC

  Medicare reassignment Care Compare group NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Medstar Medical Group II LLC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1376887844
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Montgomery General Hospital, Inc.

  • General Acute Care Hospital
  • Olney, MD
  • NPI 1114922341

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1821074014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 PRINCE PHILIP DR",
            "address_2": "SUITE T-14",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321513",
            "telephone_number": "301-774-4400",
            "fax_number": "301-774-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 PRINCE PHILIP DR",
            "address_2": "SUITE T-14",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321513",
            "telephone_number": "301-774-4400",
            "fax_number": "301-774-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAM",
        "first_name": "MARC",
        "middle_name": "LYLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "D44289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090907600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emanuel Joseph Kokotakis, M.D.
• Valerie Jo Kolick, MA, LGPC
• Darrell L Kontz, PA
• Mariama Koroma, RN
• Raoul Ekoue Kouevi
• Robert J Kreitman, MP
• Lisa Naomi Krell, MA CCC/SLP
• Emily Krieger
• Schanley Dominique Kuch I
• Natasha Kumar

• Gastroenterology Physician in Olney, MD
• Providers in Olney, MD by specialty
• Gastroenterology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.