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BLERTA HAMZA
NPI 1053901702
Nurse Practitioner in Clarksburg, MD

Active since January 26, 2021PECOS EnrolledAccepts Medicare Assignment
93.55/100
CMS Quality Rating
13016 BLACKSMITH DR, CLARKSBURG, MD 20871(586) 995-9462 Get Directions Write a Review

NPPES record last updated: January 26, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Blerta Hamza NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLERTA HAMZA (NPI 1053901702) is an individual nurse practitioner in Clarksburg, Maryland, licensed in District Of Columbia (RN1038388) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1053901702
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameBLERTA HAMZA
Location Address13016 BLACKSMITH DRClarksburg, MD 20871-5312
Mailing Address110 Irving St NwWashington, DC 20010-3017
Phone(586) 995-9462
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJanuary 26, 2021
NPPES CertifiedJanuary 26, 2021
✔ NPI 1053901702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in DC · RN1038388
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
13016 BLACKSMITH DR, Clarksburg, MD 20871
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Blerta Hamza is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9032517040
PECOS Enrollment IDI20211006000089
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Blerta Hamza reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Medstar Medical Group II LLC
25 mi
Critical Care Medicine
3800 RESERVOIR RD NW
Washington, DC 20007
  • Reassigned Medicare billing, District of Columbia enrollment
  • 3,530 clinicians in this Medicare group
NPI 1205562816 (703) 558-1403
Washington Hospital Center Corp
26 mi
Nurse Practitioner
110 IRVING ST NW, MEDICAL AFFAIRS
Washington, DC 20010
  • Reassigned Medicare billing, District of Columbia enrollment
  • 264 clinicians in this Medicare group
NPI 1376627406 (202) 877-5284

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
53 services53 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
28 services28 patients
Telephone medical discussion with physician, 5-10 minutes 99441
A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.
27 services26 patients
Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) G0296
This visit involves discussing the necessity of a lung cancer screening using a low dose CT scan. It's a chance to determine if you're eligible for the test and to make an informed decision about proceeding. The scan can potentially detect lung cancer early, improving treatment outcomes.
27 services27 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
21 services21 patients
Smoking and tobacco use intensive counseling, 4-10 minutes 99406
This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.
18 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20871 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

93.55/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality87.86
Promoting Interoperability100
Improvement Activities40
Cost57.31

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blerta Hamza's NPI number?

The NPI number for Blerta Hamza is 1053901702. It was assigned to this individual provider in the NPPES registry on January 26, 2021.

Where is Blerta Hamza located?

Blerta Hamza practices at 13016 Blacksmith Dr, Clarksburg, MD 20871. The listed phone number is (586) 995-9462.

What is Blerta Hamza's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Blerta Hamza enrolled in Medicare?

Yes. Blerta Hamza is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Blerta Hamza's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Blerta Hamza reassigns Medicare benefits to 2 organizations: Medstar Medical Group II LLC (Washington, DC) and Washington Hospital Center Corp (Washington, DC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Blerta Hamza's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Blerta Hamza was last updated on January 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.