Individual provider Active NPI

Kerri Peschock, RN,MS,CRNA

  • Certified Registered Nurse Anesthetist
  • Baltimore, MD
National Provider Identifier
1326427246
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN616564 Issued in PA
Practice address
5801 Smith Ave. Suite 210
Baltimore, MD 21209
Phone
(410) 735-6665
NPI assigned
May 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN616564 PA
Certified Registered Nurse Anesthetist 367500000X RN616564 PA Primary

Addresses

Primary practice location

5801 Smith Ave. Suite 210
Baltimore, MD 21209

Mailing address

113 Mizel LN
Johnstown, PA 15902-1328
Phone (814) 421-0737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160914001277 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658667803 Reassigns benefits to 2 organizations
I20180201001172 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658667803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia, Pennsylvania , LLCGroup PAC ID 7517960834, 302 clinicians

Practice addresses (Care Compare)

206 E Brown St
East Stoudsburg, PA 18301-3006
Phone (570) 421-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Jun 25, 2017 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
University of Maryland Medical System Corporation Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2018 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jun 25, 2017 Accepting new patients
North American Partners in Anesthesia, Pennsylvania , LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2018 Accepting new patients
Maryland Expresscare LLC CurrentSince Jan 1, 2018 Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

620 Howard Ave
Fl 7
Altoona, PA 16601
Phone (814) 943-5901

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

815 Freeport Rd
Pittsburgh, PA 15215
Phone (412) 784-4000

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1326427246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 MIZEL LN",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159021328",
            "telephone_number": "814-421-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 SMITH AVE. SUITE 210",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21209",
            "telephone_number": "410-735-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESCHOCK",
        "first_name": "KERRI",
        "credential": "RN,MS,CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-26",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN616564",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN616564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.