Ornela Dervishaj Kutzke, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

MD467781 Issued in PA

Practice address

5530 Wisconsin Ave Ste 711
Chevy Chase, MD 20815-4401

Phone

(917) 704-0465

NPI assigned

Jan 6, 2015

Last updated

Apr 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA, MD3 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 3

Specialty

Plastic and Reconstructive Surgery

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Agnes Healthcare IncGroup PAC ID 9830092733, 265 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Agnes Hospital Hospital, Baltimore, MD, CCN 210011

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• St Agnes Healthcare Inc

  dba Integrated Specialists Group

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1144250176
  Medicare reassignment Care Compare group NPD
• Affiliates in Plastic Surgery, LLC

  • Plastic Surgery Physician
  • Alexandria, VA
  • NPI 1164848529

  DC

  Medicare reassignment NPD
• Dr. Ornela Kutzke LLC

  • Plastic Surgery Physician
  • Bethesda, MD
  • NPI 1740976992
  Authorized official Same address or phone
• Affiliates in Plastic Surgery, LLC

  dba Shady Grove Surgicenter

  • Plastic and Reconstructive Surgery Physician
  • Rockville, MD
  • NPI 1336863844
  NPD
• St Agnes Healthcare Inc

  • Diagnostic Radiology Physician
  • Baltimore, MD
  • NPI 1780615922
  NPD

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

• St. Agnes Healthcare, Inc.

  dba St.Agnes Hospital

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1245274901
  Care Compare affiliation

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

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1932597416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 WISCONSIN AVE STE 711",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154401",
            "telephone_number": "917-704-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 WISCONSIN AVE STE 711",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154401",
            "telephone_number": "917-704-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTZKE",
        "first_name": "ORNELA",
        "middle_name": "DERVISHAJ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-06",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD467781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priyanka Kumar
• Kung Plastic Surgery, P.a.
• David S. Kung, M.D.
• Timothy Cooper Kunkle, DDS, MD
• Laura Kurzius, PHD
• Patricia Jane Kwiatkowski, CRNA
• Nicholas Joseph Kyak, DPT
• Phyo Kyaw
• L. Mark Gross, DDS, PA
• Lauren Mary La Bella

• Plastic Surgery Physician in Chevy Chase, MD
• Providers in Chevy Chase, MD by specialty
• Plastic Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.
• 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.