Wellness Legacy LLC
A Medicare group practice based in Bel Air, MD: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 1052743457), with 7 clinicians.
Medicare enrollment
Medicare enrollment files- PAC ID
- 1052743457
- Provider type
- Part B Supplier - Clinic/Group Practice
- Enrolled in
- MD
- Enrollments
- 1
- Group size
- 5 clinicians
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Practice locations
- 2
Enrollment records 1
| Enrollment ID | State | Provider type | NPI |
|---|---|---|---|
| O20191122000371 | MD | Part B Supplier - Clinic/Group Practice | 1134777576 |
NPIs in this group 2
NPPES NPI RegistryThese NPI records belong to the same enrolled organization. Each has its own page.
-
Wellness Legacy LLC
- Nurse Practitioner
- Bel Air, MD
- NPI 1134777576
-
Wellness Legacy LLC
- Psychiatric/Mental Health Nurse Practitioner
- Towson, MD
- NPI 1992433916
Practice locations
- Towson, MD1
- Bel Air, MD1
Clinicians 7
Clinicians who reassign their Medicare benefits to this group (7) or whom Care Compare lists as members (5).
-
Kevin Brown, CRNP-PMH
- Psychiatric/Mental Health Nurse Practitioner
- Bel Air, MD
- NPI 1740919190
-
Stephen J Condouris, CRNP
- Nurse Practitioner
- Baltimore, MD
- NPI 1669994505
-
Phoebe Gene Bautista Delos Reyes, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Bel Air, MD
- NPI 1093420283
-
Lera Salvatierra Ison, CRNP- F
- Family Nurse Practitioner
- Baltimore, MD
- NPI 1952787400
-
Mark Anthony Bergonia Ison, CRNP- PMH
- Psychiatric/Mental Health Nurse Practitioner
- Baltimore, MD
- NPI 1881152783
-
Samantha Jones, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Bel Air, MD
- NPI 1659981264
-
Luisito A Torregosa, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Bel Air, MD
- NPI 1790441590
Sources for this page
- Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
- Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
- NPPES NPI Registry: the names and addresses of the NPIs above.