Individual provider Active NPI

Janette Kroenke, NP

  • Nurse Practitioner
  • Perryville, MD
National Provider Identifier
1205560653
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R198389 Issued in MD
Practice address
4853 Pulaski Hwy Ste 300
Perryville, MD 21903-1626
Phone
(410) 642-2289
NPI assigned
Jul 12, 2022
Last updated
Jul 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 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 R198389 MD Primary

Addresses

Primary practice location

4853 Pulaski Hwy Ste 300
Perryville, MD 21903-1626

Mailing address

PO Box 7356
Lancaster, PA 17604-7356

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221011000443 MD Practitioner - Nurse Practitioner 0840676110 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
Telehealth
Offers telehealth services
Group practices
Union Hospital of Cecil CountyGroup PAC ID 6901719822, 281 clinicians
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians

Practice addresses (Care Compare)

106 Bow St
Elkton, MD 21921-5544
Phone (410) 398-4000

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.57 of 100Reported as group
Quality
59.34
Promoting interoperability
89
Improvement activities
40
Cost
75.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R198389MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County CurrentSince Sep 7, 2022 Accepting new patients
Union Hospital of Cecil County CurrentSince Sep 7, 2022 Accepting new patients
Union Hospital of Cecil County Past Accepting new patients

Locations

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

4863 Pulaski Hwy
Ste 300
Perryville, MD 21903
Phone (410) 642-2289

4853 Pulaski Hwy
Ste 300
Perryville, MD 21903
Phone (410) 642-2289

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1205560653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7356",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176047356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4853 PULASKI HWY STE 300",
            "city": "PERRYVILLE",
            "state": "MD",
            "postal_code": "219031626",
            "telephone_number": "410-642-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROENKE",
        "first_name": "JANETTE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R198389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perryville, MD

Sources for this page

Verify at the official NPI Registry.