Individual provider Active NPI

Jessica Lynn Pucci, CRNP

  • Family Nurse Practitioner
  • Prince Frederick, MD
National Provider Identifier
1497413298
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R223189 Issued in MD
Practice address
110 Hospital Rd Ste 101
Prince Frederick, MD 20678-4019
Phone
(410) 535-8195
Fax
(443) 899-1038
NPI assigned
Nov 30, 2021
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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 R223189 MD Primary

Addresses

Primary practice location

110 Hospital Rd Ste 101
Prince Frederick, MD 20678-4019

Mailing address

110 Hospital Rd Ste 101
Prince Frederick, MD 20678-4019
Phone (410) 535-8195

Other names 1

  • Jessica Lynn Erisman Former name

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
I20220208002689 MD Practitioner - Nurse Practitioner 4789077025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Calverthealth Medical Group, LLCGroup PAC ID 2163562695, 50 clinicians

Practice addresses (Care Compare)

110 Hospital Rd
Suite 101
Prince Frederick, MD 20678-4019
Phone (410) 535-8195

Merit-based Incentive Payment System (MIPS)

Final score
86.48 of 100Reported as group
Quality
74.54
Promoting interoperability
99
Improvement activities
40
Cost
81.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R223189MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Calverthealth Medical Group, LLC Family CurrentSince Sep 1, 2024 Accepting new patients
Maryland Primary Care Physicians, LLC CurrentSince Jan 24, 2022 Accepting new patients
Calverthealth Medical Group, LLC Current Accepting new patients
Calverthealth Medical Group, LLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

8924 Chesapeake Ave
North Beach, MD 20714
Phone (410) 257-7279

110 Hospital Rd
Ste 101
Prince Frederick, MD 20678
Phone (410) 535-8176

625 Solomons Island Rd N
Prince Frederick, MD 20678
Phone (410) 414-2788

125 Shoreway Dr
Ste 120
Queenstown, MD 21658
Phone (410) 643-7800

1036 Saint Nicholas Dr
Unit 101
Waldorf, MD 20603
Phone (240) 261-7170

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, 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": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1497413298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HOSPITAL RD STE 101",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784019",
            "telephone_number": "410-535-8195",
            "fax_number": "443-899-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HOSPITAL RD STE 101",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784019",
            "telephone_number": "410-535-8195",
            "fax_number": "443-899-1038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCCI",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R223189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "ERISMAN",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Prince Frederick, MD

Sources for this page

Verify at the official NPI Registry.