MR. ILYA ROZENBERG MS/CRNP NPI 1467460865

NPI Information

  • NPI: 1467460865
  • Provider Name: MR. ILYA ROZENBERG, MS/CRNP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 7452 BALTIMORE ANNAPOLIS BLVD
    SUITE 107
    GLEN BURNIE, MD
    ZIP 21061
  • Phone: (410) 766-1544

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NPI Details

MR. Ilya Rozenberg, MS/CRNP is a psychiatric/mental health nurse practitioner in Glen Burnie, MD with 25 years of experience. MR. Ilya Rozenberg, MS/CRNP NPI is 1467460865. 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:

7452 BALTIMORE ANNAPOLIS BLVD
SUITE 107
GLEN BURNIE, MD
ZIP 21061-547
Phone: (410) 766-1544
Fax: (410) 766-1551

The NPI 1467460865 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 office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Injection, paliperidone palmitate extended release, 1 mg (HCPCS:J2426)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)

The enumeration date for this NPI number is 8/3/2006 and was last updated on 10/3/2014.

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
1363LP0808XNurse PractitionerPsychiatric/Mental HealthR143360MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1402464800MEDICAIDMARYLAND
2559LE852MEDICARE PINMARYLAND
3P62941MEDICARE UPINMARYLAND
4361LM146MEDICARE ID-TYPE UNSPECIFIEDMARYLAND
5463350400MEDICAIDMARYLAND

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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