Justine S Ellerman, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R191521 Issued in MD

Practice address

400 Ball Rd
Saint Leonard, MD 20685-2116

Phone

(516) 754-3268

NPI assigned

Jun 14, 2011

Last updated

Jun 14, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Nurse Practitioner

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Shah and Associates LLCGroup PAC ID 6103901574, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Shah & Associates LLC

  • Clinical Neuropsychologist
  • Leonardtown, MD
  • NPI 1669686432
  Medicare reassignment Care Compare group NPD
• Shah & Associates LLC

  • Psychiatry Physician
  • Prince Frederick, MD
  • NPI 1750164778

  Psychiatric/Mental Health

  NPD

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1043505324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 76",
            "city": "SAINT LEONARD",
            "state": "MD",
            "postal_code": "206850076",
            "telephone_number": "516-754-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BALL RD",
            "city": "SAINT LEONARD",
            "state": "MD",
            "postal_code": "206852116",
            "telephone_number": "516-754-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLERMAN",
        "first_name": "JUSTINE",
        "middle_name": "S",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R191521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Place Just for Me
• Angelic Home Care Inc.
• Jessica Marie Bullis, LMSW
• Chesapeake Health Services, LLC
• Mackenzie Anne Craig
• Gilead Christian Counseling LLC
• Green Feather Therapy
• Guaranteed Care Access
• Erica Joy, MS CCC-SLP
• Zachary Jon Kirkwood

• Psychiatric/Mental Health Nurse Practitioner in Saint Leonard, MD
• Providers in Saint Leonard, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.