Nicole Ratajczak, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP025878 Issued in PA

Practice address

1705 Warren Ave Ste 101-103
Williamsport, PA 17701-2647

Phone

(570) 321-2020

NPI assigned

Jul 13, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Wenner Former name

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, 2,775 clinicians

Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Evangelical Medical Services OrganizationGroup PAC ID 9133033087, 255 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellspan Evangelical Community Hospital Hospital, Lewisburg, PA, CCN 390013

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nratajczak485958@wellspan.direct-ci.com

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

• Evangelical Medical Services Organization

  • Surgery Physician
  • Lewisburg, PA
  • NPI 1205928967

  PA

  Medicare reassignment Care Compare group NPD
• Wellspan Medical Group

  • Gastroenterology Physician
  • York, PA
  • NPI 1669770004

  PA

  Medicare reassignment Care Compare group NPD
• Susquehanna Physician Services

  • Cardiovascular Disease Physician
  • Williamsport, PA
  • NPI 1861431116

  Nurse Practitioner, PA

  Medicare reassignment NPD
• Phoenix Rehabilitation and Health Services, Inc.

  • Chiropractor
  • State College, PA
  • NPI 1245588946
  Care Compare group
• Phoenix Rehabilitation and Health Services, Inc.

  • Physical Therapist
  • Cranberry Township, PA
  • NPI 1720084155
  Care Compare group
• Wellspan Medical Group

  • Podiatrist
  • Chambersburg, PA
  • NPI 1033897228
  Care Compare group
• Wellspan Medical Group

  • Pulmonary Disease Physician
  • York, PA
  • NPI 1073756672
  Care Compare group
• Wellspan Medical Group

  • Podiatrist
  • Greencastle, PA
  • NPI 1336827526
  Care Compare group
• Wellspan Medical Group

  • Podiatrist
  • Fayetteville, PA
  • NPI 1700567260
  Care Compare group
• Wellspan Medical Group

  • Urology Physician
  • Gettysburg, PA
  • NPI 1790195576
  Care Compare group
• Wellspan Medical Group

  • Neurology Physician
  • York, PA
  • NPI 1831251792
  Care Compare group
• Wellspan Medical Group

  • Diagnostic Radiology Physician
  • York, PA
  • NPI 1952587727
  Care Compare group

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

• Evangelical Community Hospital

  • General Acute Care Hospital
  • Lewisburg, PA
  • NPI 1124076039

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1093449373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900",
            "telephone_number": "888-647-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 WARREN AVE STE 101-103",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177012647",
            "telephone_number": "570-321-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Lewisburg",
            "state": "PA",
            "postal_code": "178376343",
            "country_code": "US",
            "telephone_number": "570-768-4646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RATAJCZAK",
        "first_name": "NICOLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP025878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "WENNER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Alejandro Ramon Cubillos
• Cerise Ramsey
• Ganga Ranasuriya
• Mazher Rasool, M.D.
• Amanda Rathburn, M.S.W.
• Lauren Rauch, MS OTR/L
• Recovery Community Connection Inc
• Redka Behavior Services, LLC
• James Wilson Redka, M.D.

• All providers in Williamsport, PA
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.