Individual provider Active NPI

Andre Bojan Gvozden, M.D.

  • Pediatrics Physician
  • Millersville, MD
National Provider Identifier
1912960501
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0026823 Issued in MD
Practice address
8601 Veterans Hwy
Suite 200
Millersville, MD 21108-1547
Phone
(410) 729-0690
Fax
(410) 729-4057
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0026823 MD Primary

Addresses

Primary practice location

8601 Veterans Hwy
Suite 200
Millersville, MD 21108-1547

Mailing address

251 Najoles Rd Ste E
Millersville, MD 21108-2519
Phone (107) 290-6904

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
I20220613000142 MD Practitioner - Pediatric Medicine 3072991512 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0026823MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians CurrentSince May 1, 2022 Accepting new patients
Johns Hopkins Community Physicians, Inc Pediatrics Current Accepting new patients
Johns Hopkins Community Physicians, Inc CurrentSince May 1, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1912960501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 NAJOLES RD STE E",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211082519",
            "telephone_number": "107-290-6904",
            "fax_number": "410-729-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 VETERANS HWY",
            "address_2": "SUITE 200",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081547",
            "telephone_number": "410-729-0690",
            "fax_number": "410-729-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GVOZDEN",
        "first_name": "ANDRE",
        "middle_name": "BOJAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2024-03-14",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0026823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millersville, MD

Sources for this page

Verify at the official NPI Registry.