Individual provider Active NPI

Caroline Fidyk Pratz, CRNP

  • Acute Care Nurse Practitioner
  • Baltimoe, MD
National Provider Identifier
1033346200
Registry record updated Jul 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R149679 Issued in MD
Practice address
401 N. Broadway
Baltimoe, MD 21231
Phone
(410) 502-8010
NPI assigned
Jun 16, 2009
Last updated
Jul 23, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R149679 MD Primary

Addresses

Primary practice location

401 N. Broadway
Baltimoe, MD 21231

Mailing address

401 N. Broadway
Baltimoe, MD 21231
Phone (410) 502-8010

Other identifiers 1

IdentifierTypeStateIssuer
419806900MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200212000727 PA Practitioner - Nurse Practitioner 2163563917 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, shared by 15 NPIs, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127

3400 Civic Ctr Blvd 2
Symp MGMT/Pall Care
Philadelphia, PA 19104-5127
Phone (215) 614-1618

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Jan 13, 2020 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 13, 2020 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 13, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3400 Civic Center Blvd
#2
Philadelphia, PA 19104
Phone (215) 615-0063

3400 Civic Center Blvd
#2W
Philadelphia, PA 19104
Phone (215) 614-1618

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279843200000",
    "number": "1033346200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N. BROADWAY",
            "city": "BALTIMOE",
            "state": "MD",
            "postal_code": "21231",
            "telephone_number": "410-502-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N. BROADWAY",
            "city": "BALTIMOE",
            "state": "MD",
            "postal_code": "21231",
            "telephone_number": "410-502-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATZ",
        "first_name": "CAROLINE",
        "middle_name": "FIDYK",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2010-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R149679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419806900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimoe, MD

Sources for this page

Verify at the official NPI Registry.