Individual provider Active NPI

Priscilla Benewaah, CRNP

  • Family Nurse Practitioner
  • Rosedale, MD
National Provider Identifier
1053715508
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R190153 Issued in MD
Practice address
8386 Old Philadelphia Rd
Rosedale, MD 21237-2938
Phone
(410) 499-4707
NPI assigned
Oct 13, 2014
Last updated
Oct 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R190153 MD Primary

Addresses

Primary practice location

8386 Old Philadelphia Rd
Rosedale, MD 21237-2938

Mailing address

8386 Old Philadelphia Rd
Rosedale, MD 21237-2938
Phone (410) 499-4707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141203001555 MD Practitioner - Nurse Practitioner 6901128875 Reassigns benefits to 1 organization
I20141203001658 DC Practitioner - Nurse Practitioner 6901128875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peace Healthcare IncGroup PAC ID 7517253727, 2 clinicians

Practice addresses (Care Compare)

6806 Holabird Ave
Dundalk, MD 21222-1784
Phone (410) 237-7188

8203 Harford Rd
Parkville, MD 21234-5888
Phone (410) 779-9175

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R190153MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peace Healthcare Inc Current Accepting new patients
Peace Healthcare Home Health Agency, Inc Current Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients
Peace Healthcare Inc Past Accepting new patients

Locations

8203 Harford Rd
Parkville, MD 21234
Phone (410) 779-9175

Organizations & group practices 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1053715508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8386 OLD PHILADELPHIA RD",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212372938",
            "telephone_number": "410-499-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8386 OLD PHILADELPHIA RD",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212372938",
            "telephone_number": "410-499-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEWAAH",
        "first_name": "PRISCILLA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R190153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, MD

Sources for this page

Verify at the official NPI Registry.