Autumn Puchalsky

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP028867 Issued in PA

Practice address

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

Phone

(717) 724-6450

NPI assigned

Dec 11, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Penn State Health Medical Group LLCGroup PAC ID 8729351077, 720 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Penn State Health Holy Spirit Medical Center Hospital, Camp Hill, PA, CCN 390004
• Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256
• Penn State Health Hampden Medical Center Hospital, Enola, PA, CCN 390336

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Penn State Health Medical Group, LLC

  • Hematology & Oncology Physician
  • Harrisburg, PA
  • NPI 1861988644
  Medicare reassignment Care Compare group NPD
• Penn State Health Medical Group, LLC

  • Diagnostic Radiology Physician
  • Harrisburg, PA
  • NPI 1457824013
  NPD
• Penn State Health Medical Group, LLC

  • Cardiovascular Disease Physician
  • Camp Hill, PA
  • NPI 1134874779
  NPD (past)

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

• Penn State Health Hampden Medical Center

  • General Acute Care Hospital
  • Enola, PA
  • NPI 1164029658
  Care Compare affiliation
• Penn State Health Holy Spirit Medical Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Camp Hill, PA
  • NPI 1659566008

  Hospital

  Care Compare affiliation
• Penn State Health Holy Spirit Medical Center

  • General Acute Care Hospital
  • Camp Hill, PA
  • NPI 1881690212
  Care Compare affiliation
• The Milton S Hershey Medical Center

  • General Acute Care Hospital
  • Hershey, PA
  • NPI 1568435477
  Care Compare affiliation

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1235906041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 POPLAR CHURCH RD STE 400",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112203",
            "telephone_number": "717-724-6450"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCHALSKY",
        "first_name": "AUTUMN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2024-02-07",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP028867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Progressive Dental Concepts LLC (Poplar Square Dental)
• Steven Allen Prophet, MD
• Kateryna Prosvirnina
• Christina Prudencio, CRNP
• Maria Estela O Prudencio, MD
• Coreen A Puetz
• Erin Purcell, RN
• Leah Purdue
• William Purje, DC
• Colinda R Purkett

• Family Nurse Practitioner in Camp Hill, PA
• Providers in Camp Hill, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.