Kelley J. Stefancik, C.R.N.P.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

R120913 Issued in MD

Practice address

255 Hospital Dr Ste 208
Glen Burnie, MD 21061-5801

Phone

(410) 553-8160

Fax

(410) 553-8159

NPI assigned

Aug 17, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MD

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, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Maryland Neurosurgery Associates P aGroup PAC ID 9133187750, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of MD Baltimore Washington Medical Center Hospital, Glen Burnie, MD, CCN 210043

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kstefancik11717@direct.umm.edu

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.

• University of Maryland Neurosurgery Associates P a

  • Neurological Surgery Physician
  • Columbia, MD
  • NPI 1639119035
  Medicare reassignment Care Compare group NPD
• University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1477530624
  Medicare reassignment NPD
• University of Maryland Community Medical Group, Inc.

  • Psychiatry Physician
  • La Plata, MD
  • NPI 1679393854
  NPD
• Clifford T. Solomon, MD

  • Neurological Surgery Physician
  • Annapolis, MD
  • NPI 1073716973
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

• Baltimore Washington Medical Center Inc.

  • General Acute Care Hospital
  • Glen Burnie, MD
  • NPI 1124016696
  Care Compare affiliation

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1194717983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "address_2": "STE 803",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615803",
            "telephone_number": "410-553-8160",
            "fax_number": "410-553-8159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 HOSPITAL DR STE 208",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615801",
            "telephone_number": "410-553-8160",
            "fax_number": "410-553-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANCIK",
        "first_name": "KELLEY",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "C.R.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MD",
            "license": "R120913",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MD",
            "license": "R120913",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R120913",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "R120913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRAVO HEALTH",
            "identifier": "216966",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3405544",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11583185",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS BLUE SHIELD",
            "identifier": "546903-14 8756-0002",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "680010600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michele Stanton, LCSW-C
• Kathryn E Staples, LCSW-C
• Matthew Staso, PHARM D
• Statpoint Medical Inc.
• Laura Steensen, PSYD
• Karey Morgan Steiner, LCSW-C
• Jennifer Steinle, LCPC
• Krystina Stello
• Karen Patel K Stengel, M.D.
• Kishma K Stephens, CPNP-PC

• Surgery Physician in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.