Individual provider Active NPI

Elyzabeth Ruta Savage Goralski, CRNP

  • Family Nurse Practitioner
  • Oakland, MD
National Provider Identifier
1265884464
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R199245 Issued in MD
Practice address
311 N 4TH St
Oakland, MD 21550-1371
Phone
(301) 334-8171
Fax
(301) 334-1819
NPI assigned
Jul 12, 2016
Last updated
Mar 10, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R199245 MD Primary

Addresses

Primary practice location

311 N 4TH St
Oakland, MD 21550-1371

Mailing address

311 N 4TH St
Oakland, MD 21550-1371
Phone (301) 334-8171

Other identifiers 1

IdentifierTypeStateIssuer
111822600MedicaidMD

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
I20160916000949 MD Practitioner - Nurse Practitioner 5597052688

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R199245MDMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1265884464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N 4TH ST",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501371",
            "telephone_number": "301-334-8171",
            "fax_number": "301-334-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N 4TH ST",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501371",
            "telephone_number": "301-334-8171",
            "fax_number": "301-334-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORALSKI",
        "first_name": "ELYZABETH",
        "middle_name": "RUTA SAVAGE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R199245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111822600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, MD

Sources for this page

Verify at the official NPI Registry.