Individual provider Active NPI

Stacey Barbara Solomon, CRNP

  • Nurse Practitioner
  • Camp Hill, PA
National Provider Identifier
1104559939
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP025574 Issued in PA
Practice address
875 Poplar Church Rd Ste 400
Camp Hill, PA 17011-2203
Phone
(717) 724-6450
Fax
(717) 724-6451
NPI assigned
Jul 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP025574 PA Primary

Addresses

Primary practice location

875 Poplar Church Rd Ste 400
Camp Hill, PA 17011-2203

Mailing address

500 University Dr
MC Ca410
Hershey, PA 17033-2360

Other practice location 1

20 Capital Dr
Harrisburg, PA 17110-9446
Phone (717) 724-6450

Other practice location 2

1211 Forge Rd Ste 300
Carlisle, PA 17013-3183
Phone (717) 724-6450

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssolomon2@direct.psu.edu

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
I20220722001258 PA Practitioner - Nurse Practitioner 0648651554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

875 Poplar Church Rd
Suite 400
Camp Hill, PA 17011-2203
Phone (717) 724-6450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP025574PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2022 Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2022 Accepting new patients
Penn State Health Medical Group, LLC Past Accepting new patients

Locations

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

875 Poplar Church Rd
Ste 400
Camp Hill, PA 17011
Phone (717) 975-0900

1211 Forge Rd
Ste 200
Carlisle, PA 17013
Phone (717) 241-5070

1211 Forge Rd
Ste 300
Carlisle, PA 17013
Phone (717) 218-3920

20 Capital Dr
Harrisburg, PA 17110
Phone (717) 724-6397

20 Capital Dr
Ste 100
Harrisburg, PA 17110
Phone (717) 724-6397

500 University Dr
#410
Hershey, PA 17033
Phone (717) 531-1159

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

Interoperability endpoints

  • Direct secure messaging: ssolomon2@direct.psu.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1104559939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "address_2": "MC CA410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 POPLAR CHURCH RD STE 400",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112203",
            "telephone_number": "717-724-6450",
            "fax_number": "717-724-6451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Capital Dr",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171109446",
            "country_code": "US",
            "telephone_number": "717-724-6450",
            "fax_number": "717-724-6451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1211 Forge Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Carlisle",
            "state": "PA",
            "postal_code": "170133183",
            "country_code": "US",
            "telephone_number": "717-724-6450",
            "fax_number": "717-724-6451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "STACEY",
        "middle_name": "BARBARA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP025574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssolomon2@direct.psu.edu",
            "affiliation": "N",
            "address_1": "875 Poplar Church Rd Ste 400",
            "city": "Camp Hill",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170112203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

Verify at the official NPI Registry.