Elle Cruz Kunisch, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SP020893 Issued in PA

Practice address

1850 E Park Ave Ste 302
State College, PA 16803-6706

Phone

(814) 278-4680

Fax

(814) 235-1523

NPI assigned

Mar 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Elvira G. Martinez Former name

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

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.

• Concertocare Medical Group of Pennsylvania, PC

  • Internal Medicine Physician
  • Camp Hill, PA
  • NPI 1235969171
  Medicare reassignment NPD

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1255834941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 GHANER DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168031169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE STE 302",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-278-4680",
            "fax_number": "814-235-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNISCH",
        "first_name": "ELLE",
        "middle_name": "CRUZ",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-09",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP020893",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP020893",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP020893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELVIRA",
            "last_name": "MARTINEZ",
            "middle_name": "G.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jillian Ann Kulago, DR. OF PHARMACY
• Melissa Kulbis, AGNP
• Bradley Scott Kulig, D.C.
• Julie Elyse Kulig, D.C.
• Shama Anil Kulkarni, DMD
• Camryn Nicole Kurilla, NCC
• Linda Joyce Kurtz, MD
• Madison Kurtz, PA-C
• Brian C Kwon, DMD
• Kevin Peter Labosky, DMD

• Adult Health Nurse Practitioner in State College, PA
• Providers in State College, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.