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MR. JOEL KERTZNUS M.D.
NPI 1487639308
Internal Medicine - Gastroenterology in Hialeah, FL

Active since December 14, 2005PECOS EnrolledAccepts Medicare Assignment
2140 W 68TH ST, SUITE 300, HIALEAH, FL 33016(305) 822-4107(305) 822-5086 Get Directions Write a Review

NPPES record last updated: March 21, 2013. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mr. Joel Kertznus M.d. NPPES

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

MR. JOEL KERTZNUS M.D. (NPI 1487639308) is an individual gastroenterology provider in Hialeah, Florida, licensed in Florida (ME89004) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1997).

NPPES Registry Identity

NPI1487639308
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameMR. JOEL KERTZNUSCredential: M.D.
Location Address2140 W 68TH ST, SUITE 300Hialeah, FL 33016-1815
Mailing Address2140 W 68th St, Suite 305Hialeah, FL 33016-1815 · (305) 822-4107 · Fax (786) 497-2989
Phone(305) 822-4107
Fax(305) 822-5086
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateDecember 14, 2005
Last NPPES UpdateMarch 21, 2013
✔ NPI 1487639308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in FL · ME89004
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
2140 W 68TH ST, Hialeah, FL 33016
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Other Identifiers 2

Medicaid278181600FL
Medicare PINA37978FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

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

Mr. Joel Kertznus M.d. 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 ID8022067941
PECOS Enrollment IDI20080308000085
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 Reassignment

Medicare enrollment records show Joel Kertznus reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Digestive Medicine Associates
Same address
Gastroenterology
2140 W 68TH ST, SUITE 300
Hialeah, FL 33016
  • Reassigned Medicare billing, Florida enrollment
  • 20 clinicians in this Medicare group
NPI 1700867488 (305) 822-4107

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 4

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.

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.
45 services35 patients
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.
29 services29 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
20 services20 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
19 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33016 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
$141.56 typical visit price
range $60.92 – $187.05
Typical copayment $35.39 (range $15.23 – $46.76)
Most-billed visit code 99204
Established Patient
$107.17 typical visit price
range $18.99 – $150.24
Typical copayment $26.79 (range $4.74 – $37.56)
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.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tape, non-waterproof, per 18 square inches A4450
DME-Medical/Surgical Supplies · category DA000N
2 suppliers13 claims119 services$0.07 avg. paid by Medicare
Tape, waterproof, per 18 square inches A4452
DME-Medical/Surgical Supplies · category DA000N
2 suppliers14 claims131 services$0.34 avg. paid by Medicare
Collagen dressing, sterile, size 16 sq. in. or less, each A6021
DME-Medical/Surgical Supplies · category DA023N
2 suppliers11 claims1,549 services$20.42 avg. paid by Medicare
Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing A6238
DME-Medical/Surgical Supplies · category DA023N
2 suppliers24 claims645 services$22.05 avg. paid by Medicare
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing A6403
DME-Medical/Surgical Supplies · category DA023N
2 suppliers23 claims1,992 services$0.40 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROBERTO A. MOYA, MD, PA
Specialist
2140 W 68TH ST, SUITE 201
HIALEAH, FL 33016
Miami-Dade County (305) 826-4046
MAIBYS MOLINA ARNP
Nurse Practitioner (Adult Health)
2140 W 68TH ST
HIALEAH, FL 33016
Miami-Dade County (305) 332-2065
UROLOGY SPECIALISTS LLC
Urology
2140 W 68TH ST, SUITE 200
HIALEAH, FL 33016
Miami-Dade County (305) 822-7227
MARIA B BITTAR PT
Physical Therapist
2140 W 68TH ST, STE 101
HIALEAH, FL 33016
Miami-Dade County (305) 822-8815
PEDRO L CARRILLO MD PA
Internal Medicine
2140 W 68TH ST, 308
HIALEAH, FL 33016
Miami-Dade County (305) 824-1117
BENIDECTO FERNANDEZ MD
Internal Medicine (Rheumatology)
2140 W 68TH ST, STE 406
HIALEAH, FL 33016
Miami-Dade County (305) 362-4979
MDM CARDIOLOGY ASSOCIATES
Internal Medicine (Cardiovascular Disease)
2140 W 68TH ST, STE 403
HIALEAH, FL 33016
Miami-Dade County (305) 698-7828
MR. JULIAN MARQUEZ MD
General Practice
2140 W 68TH ST, SUITE 401-A
HIALEAH, FL 33016
Miami-Dade County (305) 827-9939

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 Joel Kertznus's NPI number?

The NPI number for Joel Kertznus is 1487639308. It was assigned to this individual provider in the NPPES registry on December 14, 2005.

Where is Joel Kertznus located?

Joel Kertznus practices at 2140 W 68th St Suite 300, Hialeah, FL 33016. The listed phone number is (305) 822-4107.

What is Joel Kertznus's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Joel Kertznus enrolled in Medicare?

Yes. Joel Kertznus 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 organization bills Medicare for Joel Kertznus's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Joel Kertznus reassigns Medicare benefits to Digestive Medicine Associates (Hialeah, FL). The 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 Joel Kertznus's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Joel Kertznus accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AmeriHealth Caritas Next and AvMed and 5 other insurers list Joel Kertznus as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Joel Kertznus was last updated on March 21, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.