Individual provider Active NPI

Ann M Griesacker, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Erie, PA
National Provider Identifier
1437442993
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP011370 Issued in PA
Practice address
3250 W. Lake Rd
Suite 1
Erie, PA 16505-3691
Phone
(814) 454-1085
Fax
(814) 240-3976
NPI assigned
May 17, 2011
Last updated
Jan 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP011370 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP011370 PA Primary

Addresses

Primary practice location

3250 W. Lake Rd
Suite 1
Erie, PA 16505-3691

Mailing address

3250 W. Lake Rd
Suite 1
Erie, PA 16505-3691
Phone (814) 790-4567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20130906000173 PA Practitioner - Nurse Practitioner 8628211927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay City Psychiatry, LLCGroup PAC ID 5698088953, 3 clinicians

Practice addresses (Care Compare)

3250 W Lake Rd
Suite 1
Erie, PA 16505-3691
Phone (814) 454-1085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP011370PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Focused Care. CurrentSince Jun 17, 2019 Accepting new patients
Bay City Psychiatry, LLC CurrentSince May 1, 2021 Accepting new patients

Locations

3250 W Lake Rd
Ste 1
Erie, PA 16505
Phone (814) 454-1085

3250 W Lake Rd
Ste 2
Erie, PA 16505
Phone (814) 790-4567

4506 Miller Ave
Erie, PA 16509
Phone (814) 454-1085

Organizations & group practices 2

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": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1437442993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 W. LAKE RD",
            "address_2": "SUITE 1",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165053691",
            "telephone_number": "814-790-4567",
            "fax_number": "814-295-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 W. LAKE RD",
            "address_2": "SUITE 1",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165053691",
            "telephone_number": "814-454-1085",
            "fax_number": "814-240-3976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIESACKER",
        "first_name": "ANN",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-17",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP011370",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP011370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.