Individual provider Active NPI

Elsa Victoria Correa-Deleonardo, PMH-NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Reisterstown, MD
National Provider Identifier
1396222907
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R204254 Issued in MD
Practice address
217 Main St Ste B
Reisterstown, MD 21136-1213
Phone
(410) 833-0581
Fax
(410) 833-8604
NPI assigned
Jul 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X R204254 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R204254 MD Primary

Addresses

Primary practice location

217 Main St Ste B
Reisterstown, MD 21136-1213

Mailing address

217 Main St Ste B
Reisterstown, MD 21136-1213
Phone (410) 833-0581

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
I20190222000477 MD Practitioner - Nurse Practitioner 9830438670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chesapeake Behavioral Health Center, LLCGroup PAC ID 5496762155, 4 clinicians

Practice addresses (Care Compare)

217 Main St B
Reisterstown, MD 21136-1213
Phone (410) 833-0581

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R204254MDMDMedical-Surgical Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Behavioral Health Center, LLC CurrentSince Jan 1, 2019 Accepting new patients

Locations

217 Main St
Ste B
Reisterstown, MD 21136
Phone (410) 833-0581

217 Main St
#B
Reisterstown, MD 21136
Phone (410) 833-0581

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1396222907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 MAIN ST STE B",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361213",
            "telephone_number": "410-833-0581",
            "fax_number": "410-833-8604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 MAIN ST STE B",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361213",
            "telephone_number": "410-833-0581",
            "fax_number": "410-833-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA-DELEONARDO",
        "first_name": "ELSA",
        "middle_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "PMH-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MD",
            "license": "R204254",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R204254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reisterstown, MD

Sources for this page

Verify at the official NPI Registry.