Individual provider Active NPI

Rozalinde B Christodoulos, NP

  • Acute Care Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1306856737
Registry record updated May 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R185270 Issued in MD
Practice address
3016 E Pratt St
Baltimore, MD 21224-2254
Phone
(443) 226-1676
Fax
(443) 449-5684
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN142649 GA
Acute Care Nurse Practitioner 363LA2100X R185270 MD Primary

Addresses

Primary practice location

3016 E Pratt St
Baltimore, MD 21224-2254

Mailing address

3016 E Pratt St
Baltimore, MD 21224-2254
Phone (443) 226-1676

Other identifiers 1

IdentifierTypeStateIssuer
000980449AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260622001685 PA Practitioner - Nurse Practitioner 5496751885 Reassigns benefits to 1 organization
I20260623001898 NJ Practitioner - Nurse Practitioner 5496751885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

233 Mount Airy Rd
Suite 100 Advanced Picc Specialists Inc
Basking Ridge, NJ 07920-2338
Phone (443) 226-1676

78 Woodbine LN
Danville, PA 17821-8020
Phone (443) 226-1676

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN142649GAMDAcute Care Nurse Practitioner
R185270MDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Picc Specialists, Inc Current Accepting new patients

Locations

233 Mount Airy Rd
Ste 100
Basking Ridge, NJ 07920
Phone (908) 434-6008

46 Erford Rd
Camp Hill, PA 17011
Phone (717) 599-5992

78 Woodbine Ln
Danville, PA 17821
Phone (570) 275-5240

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243296000000",
    "number": "1306856737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 E PRATT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242254",
            "telephone_number": "443-226-1676",
            "fax_number": "443-449-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3016 E PRATT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242254",
            "telephone_number": "443-226-1676",
            "fax_number": "443-449-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTODOULOS",
        "first_name": "ROZALINDE",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2009-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN142649",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R185270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000980449A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.