Individual provider Active NPI

Kristen Lee Liguori, CRNP

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1417724386
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R228306 Issued in MD
Practice address
16 S Eutaw St FL 1
Baltimore, MD 21201-1606
Phone
(667) 214-1718
Fax
(410) 328-6343
NPI assigned
Dec 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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 R228306 MD Primary

Addresses

Primary practice location

16 S Eutaw St FL 1
Baltimore, MD 21201-1606

Mailing address

PO Box 64226
Baltimore, MD 21264-4226
Phone (667) 214-1734

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
I20240403000073 MD Practitioner - Nurse Practitioner 7719325281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-5191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R228306MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Surgical Associates, PA CurrentSince Feb 24, 2024 Accepting new patients
University of Maryland Surgcial Assoc PA Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

419 W Redwood St
Ste 300
Baltimore, MD 21201
Phone (410) 328-5300

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

419 W Redwood St
Fl 3
Baltimore, MD 21201
Phone (410) 328-5300

Interoperability endpoints

  • Direct secure messaging: kdziedzic449916@direct.umm.edu

Organizations & group practices 3

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": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1417724386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64226",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644226",
            "telephone_number": "667-214-1734",
            "fax_number": "410-706-6976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 S EUTAW ST FL 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011606",
            "telephone_number": "667-214-1718",
            "fax_number": "410-328-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGUORI",
        "first_name": "KRISTEN",
        "middle_name": "LEE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R228306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.