DR. DMITRY BEDERAK DNP CRNP NPI 1194490250

NPI Information

  • NPI: 1194490250
  • Provider Name: DR. DMITRY BEDERAK, DNP, CRNP
  • Classification: Nurse Practitioner - 363LG0600X
  • Specialization: Gerontology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 6701 N CHARLES ST STE 4105
    BALTIMORE, MD
    ZIP 21204
  • Phone: (443) 849-8200

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NPI Details

DR. Dmitry Bederak, DNP, CRNP is a gerontology nurse practitioner in Baltimore, MD with 5 years of experience. DR. Dmitry Bederak, DNP, CRNP NPI is 1194490250. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6701 N CHARLES ST STE 4105
BALTIMORE, MD
ZIP 21204-881
Phone: (443) 849-8200

The NPI 1194490250 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient custodial care facility, group care, or assisted living visit, typically 25 minutes (HCPCS:99335)
  • Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes (HCPCS:99336)
  • Follow-up nursing facility visit per day, typically 25 minutes (HCPCS:99309)
  • Follow-up nursing facility visit per day, typically 15 minutes (HCPCS:99308)

The enumeration date for this NPI number is 8/11/2021 and was last updated on 7/23/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult HealthR204060MARYLANDNo
2363LP2300XNurse PractitionerPrimary CareR204060MARYLANDNo
3363LG0600XNurse PractitionerGerontologyR204060MARYLANDYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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