Individual provider Active NPI

Stephanie M Entrup, CRNP

  • Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1184674491
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R096361 Issued in MD
Practice address
2401 W Belvedere Ave
Dept of Pediatrics
Baltimore, MD 21215-5216
Phone
(410) 601-8393
Fax
(410) 601-8390
NPI assigned
May 10, 2006
Last updated
Oct 18, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R096361 MD
Pediatric Hematology & Oncology Physician 2080P0207X R096361 MD
Nurse Practitioner 363L00000X R096361 MD Primary

Addresses

Primary practice location

2401 W Belvedere Ave
Dept of Pediatrics
Baltimore, MD 21215-5216

Mailing address

2401 W Belvedere Ave
Attn: Credentialing
Baltimore, MD 21215-5216
Phone (410) 601-5524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, PA2 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
I20101029000798 MD Practitioner - Nurse Practitioner 0749474146 Reassigns benefits to 1 organization
I20190416000145 PA Practitioner - Nurse Practitioner 0749474146 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Jul 6, 2010 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Apr 1, 2019 Accepting new patients
The Milton S Hershey Medical Center Physicians Group CurrentSince Apr 1, 2019 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
Sinai Hospital of Baltimore Inc Pediatric Hematology-Oncology CurrentSince Jul 6, 2010 Accepting new patients
The Milton S. Hershey Medical Center Physicians Group Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1184674491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "address_2": "ATTN: CREDENTIALING",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-5524",
            "fax_number": "410-601-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "address_2": "DEPT OF PEDIATRICS",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-8393",
            "fax_number": "410-601-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENTRUP",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "R096361",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "MD",
            "license": "R096361",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R096361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.