Individual provider Active NPI

Kristin Ronan, MD

  • Student in an Organized Health Care Education/Training Program
  • Baltimore, MD
National Provider Identifier
1477967909
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
RES000 Issued in MD
Practice address
110 S Paca St
Baltimore, MD 21201-1642
Phone
(410) 328-6289
NPI assigned
Jun 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT207406 PA
Student in an Organized Health Care Education/Training Program 390200000X RES000 MD Primary

Addresses

Primary practice location

110 S Paca St
Baltimore, MD 21201-1642

Mailing address

5501 Old York Road
Albert Einstein Medical Center
Philadelphia, PA 19141
Phone (215) 456-3221

Other practice location 1

5501 Old York Road
Albert Einstein Medical Center
Philadelphia, PA 19141
Phone (215) 456-3221

Other names 1

  • Dr. Kristin Ronan Other name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201208000428 PA Practitioner - Pediatric Medicine 4082953328 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
RES000MDMDStudent in an Organized Health Care Education/Training Program
MT207406PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc CurrentSince Sep 1, 2020 Accepting new patients
Childrens Health Care Associates, Inc Current Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Sep 1, 2020 Accepting new patients
Lancaster General Hospital Past Accepting new patients

Locations

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

Organizations & group practices 4

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1477967909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK ROAD",
            "address_2": "ALBERT EINSTEIN MEDICAL CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19141",
            "telephone_number": "215-456-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S PACA ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011642",
            "telephone_number": "410-328-6289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Road",
            "address_2": "Albert Einstein Medical Center",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19141",
            "country_code": "US",
            "telephone_number": "215-456-3221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RONAN",
        "first_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT207406",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": "RES000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "RONAN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.