Individual provider Active NPI

Mary Laura Hitchcock, CRNP

  • Women's Health Nurse Practitioner
  • York, PA
National Provider Identifier
1124072988
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
SP000141F Issued in PA
Practice address
4222 Lincoln Hwy
York, PA 17406-8083
Phone
(717) 812-7800
Fax
(717) 812-7811
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X RN037974 LA
Women's Health Nurse Practitioner 363LW0102X AP01173 LA
Women's Health Nurse Practitioner 363LW0102X SP000141F PA Primary

Addresses

Primary practice location

4222 Lincoln Hwy
York, PA 17406-8083

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 812-7800

Other identifiers 3

IdentifierTypeStateIssuer
PO0341287OtherPARAILROAD MEDICARE
565985FLTOtherPAMEDICARE
1692231MedicaidLA

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
I20060727000350 PA Practitioner - Nurse Practitioner 6709800436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

4222 Lincoln Hwy
York, PA 17406-8083
Phone (717) 812-7800

Hospital & facility affiliations

  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065
  • Upmc Hanover Hospital, Hanover, PA, CCN 390233

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN037974LAMDAmbulatory Women's Health Care Registered Nurse
AP01173LAMDWomen's Health Nurse Practitioner
SP000141FPAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Apr 3, 2017 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

1227 Baltimore St
Hanover, PA 17331
Phone (717) 646-4204

4222 Lincoln Hwy
York, PA 17406
Phone (717) 812-2050

1803 Mount Rose Ave
Ste B3
York, PA 17403
Phone (717) 851-6816

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

Interoperability endpoints

  • Direct secure messaging: mhitchcock108701@wellspan.direct-ci.com

Organizations & group practices 3

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 8

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1124072988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-812-7800",
            "fax_number": "717-812-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4222 LINCOLN HWY",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174068083",
            "telephone_number": "717-812-7800",
            "fax_number": "717-812-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITCHCOCK",
        "first_name": "MARY",
        "middle_name": "LAURA",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "LA",
            "license": "RN037974",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "LA",
            "license": "AP01173",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "PA",
            "license": "SP000141F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "PO0341287",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "565985FLT",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1692231",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.