Individual provider Active NPI

Christina Prudencio, CRNP

  • Family Nurse Practitioner
  • Camp Hill, PA
National Provider Identifier
1487104931
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP020794 Issued in PA
Practice address
100 Corporate Center Dr Ste 100
Camp Hill, PA 17011-1758
Phone
(717) 763-1174
NPI assigned
Oct 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X SP020794 PA
Family Nurse Practitioner 363LF0000X APRN 2194 HI
Family Nurse Practitioner 363LF0000X SP020794 PA Primary

Addresses

Primary practice location

100 Corporate Center Dr Ste 100
Camp Hill, PA 17011-1758

Mailing address

100 Corporate Center Dr Ste 100
Camp Hill, PA 17011-1758
Phone (717) 763-1174

Other practice location 1

130 Kailua Rd
Suit 111
Kailua, HI 96734-3420
Phone (808) 261-4411

Other practice location 2

86-260 Farrington Hwy
Waianae, HI 96792-3128
Phone (808) 697-3300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cprudencio172010@phsdirect.pinnaclehealth.org

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
I20200218000012 PA Practitioner - Nurse Practitioner 3375826886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

100 Corporate Ctr Dr
Suite 100
Camp Hill, PA 17011-1758
Phone (717) 724-0380

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.08 of 100Reported as group
Quality
76.48
Promoting interoperability
100
Improvement activities
40
Cost
77.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP020794PAMDFamily Medicine Physician
APRN 2194HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Jul 1, 2021 Accepting new patients
Pinnacle Health Medical Services Family Medicine Current Accepting new patients
Pinnacle Health Medical Services CurrentSince Jul 1, 2021 Accepting new patients
Pinnacle Health Medical Services Past Accepting new patients

Locations

100 Corporate Center Dr
Ste 100
Camp Hill, PA 17011
Phone (717) 763-1174

423 N 21st St
Ste 300
Camp Hill, PA 17011
Phone (717) 763-1174

4310 Londonderry Rd
Ste 101
Harrisburg, PA 17109
Phone (717) 724-0720

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

Interoperability endpoints

  • Direct secure messaging: cprudencio300038@upmc.direct-ci.com
  • Direct secure messaging: christina.prudencio.p1@direct.wcchc.nextgenshare.com

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.

Hospital & facility affiliations 7

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": "1475884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1487104931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CORPORATE CENTER DR STE 100",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170111758",
            "telephone_number": "717-763-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CORPORATE CENTER DR STE 100",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170111758",
            "telephone_number": "717-763-1174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Kailua Rd",
            "address_2": "Suit 111",
            "address_purpose": "LOCATION",
            "city": "Kailua",
            "state": "HI",
            "postal_code": "967343420",
            "country_code": "US",
            "telephone_number": "808-261-4411",
            "fax_number": "808-261-3322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "86-260 Farrington Hwy",
            "address_purpose": "LOCATION",
            "city": "Waianae",
            "state": "HI",
            "postal_code": "967923128",
            "country_code": "US",
            "telephone_number": "808-697-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUDENCIO",
        "first_name": "CHRISTINA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-08",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "SP020794",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN 2194",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP020794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cprudencio172010@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "100 Corporate Center Dr Ste 100",
            "city": "Camp Hill",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170111758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

Verify at the official NPI Registry.