Active NPI
Zachary Kerosky
- Rheumatology Physician
- Bethesda, MD
National Provider Identifier
1962935841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 2266
- Practice address
- 4954 N Palmer Rd
Bethesda, MD 20889-5630 - Phone
- (301) 295-4512
- Fax
- (301) 295-4164
- NPI assigned
- Apr 6, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 2266 | NE | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Rheumatology Physician | 207RR0500X | 2266 | NE | Primary |
Addresses
Primary practice location
4954 N Palmer Rd
Bethesda, MD 20889-5630
Mailing address
4954 N Palmer Rd
Bethesda, MD 20889-5630
Phone (301) 295-4512
Other practice location 1
200 Mullins Dr
Lebanon, OR 97355-3983
Phone (440) 645-4755
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201207002022 | NE | Order and Referring Only - Internal Medicine | 3870905391 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706832000000",
"number": "1962935841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4954 N PALMER RD",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208895630",
"telephone_number": "301-295-4512",
"fax_number": "301-295-5164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4954 N PALMER RD",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208895630",
"telephone_number": "301-295-4512",
"fax_number": "301-295-4164"
}
],
"practiceLocations": [
{
"address_1": "200 Mullins Dr",
"address_purpose": "LOCATION",
"city": "Lebanon",
"state": "OR",
"postal_code": "973553983",
"country_code": "US",
"telephone_number": "440-645-4755",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KEROSKY",
"first_name": "ZACHARY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-06",
"last_updated": "2024-02-02",
"certification_date": "2024-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NE",
"license": "2266",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "NE",
"license": "2266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.