Jill Anne Burgholzer, CRNP-PMH

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1050971 Issued in DC

Practice address

112 Saint Claire PL Ste 202
Stevensville, MD 21666-2193

Phone

(410) 200-6920

NPI assigned

Aug 31, 2011

Last updated

Sep 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Center for Eating Disorders PAGroup PAC ID 7315832573, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Luminis Health Anne Arundel Medical Center, Inc Hospital, Annapolis, MD, CCN 210023
• University of MD St Joseph Medical Center Hospital, Towson, MD, CCN 210063
• Medstar Washington Hospital Center Hospital, Washington, DC, CCN 090011
• Levindale Hebrew Geriatric Center and Hospital Hospital, Baltimore, MD, CCN 210064

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jburgholzer477811@direct.umm.edu

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.

• Center for Eating Disorders PA

  • Psychiatry Physician
  • Hunt Valley, MD
  • NPI 1659484400
  Medicare reassignment Care Compare group NPD
• Luminis Health Medical Group, LLC

  dba Luminis Health Maternal and Fetal Medicine

  • Maternal & Fetal Medicine Physician
  • Annapolis, MD
  • NPI 1073580205
  Medicare reassignment Care Compare group NPD
• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187

  DC

  Medicare reassignment Care Compare group NPD
• Adventist Physician Services, Inc.

  dba Adventist Medical Group

  • Physical Medicine & Rehabilitation Physician
  • Gaithersburg, MD
  • NPI 1376623207

  DC

  Medicare reassignment NPD
• Grace Medical Center, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1104151091
  Medicare reassignment NPD
• Luminis Health Medical Group, LLC

  dba Annapolis Surgical Oncology Associates

  • Surgery Physician
  • Annapolis, MD
  • NPI 1649248485

  DC

  Medicare reassignment NPD
• Sinai Hospital of Baltimore Inc

  • Surgical Critical Care Physician
  • Baltimore, MD
  • NPI 1043235666
  Medicare reassignment NPD
• University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1477530624
  Medicare reassignment NPD
• Washington Hospital Center Corp

  dba Washington Hospital Center Physicians

  • Neurological Surgery Physician
  • Washington, DC
  • NPI 1407870124
  Medicare reassignment NPD
• Peace of Mind Mental Health Services LLC

  • Psychiatry Physician
  • Easton, MD
  • NPI 1952715161
  Medicare reassignment
• Luminis Health Medical Group, LLC

  dba Anne Arundel Medical Group- Pasadena Primary Care

  • Family Medicine Physician
  • Pasadena, MD
  • NPI 1063837490
  NPD
• Luminis Health Medical Group, LLC

  dba LH Primary Care North Hanson

  • Internal Medicine Physician
  • Bowie, MD
  • NPI 1720835010
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Levindale Hebrew Geriatric Center & Hospital Inc

  • Chronic Disease Hospital
  • Baltimore, MD
  • NPI 1598740821
  Care Compare affiliation
• Luminis Health Anne Arundel Medical Center, Inc.

  dba Conexus Laboratories Inc.

  • Clinical Medical Laboratory
  • Annapolis, MD
  • NPI 1356885032

  Hospital

  Care Compare affiliation
• Luminis Health Anne Arundel Medical Center, Inc.

  • General Acute Care Hospital
  • Annapolis, MD
  • NPI 1477517225
  Care Compare affiliation
• University of Maryland St. Joseph Medical Center, LLC

  dba University of Maryland St. Joseph Medical Center

  • General Acute Care Hospital
  • Towson, MD
  • NPI 1124374079
  Care Compare affiliation
• Washington Hospital Center Corporation

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1548378235
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1538440862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 SAINT CLAIRE PL STE 202",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216662193",
            "telephone_number": "410-200-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 SAINT CLAIRE PL STE 202",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216662193",
            "telephone_number": "410-200-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGHOLZER",
        "first_name": "JILL",
        "middle_name": "ANNE",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2021-09-03",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R181825",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024176704",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "1050971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST NATIONAL",
            "identifier": "R968",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "522156095",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS-LOCAL",
            "identifier": "LM49EA",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "609550002",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Stevensville, MD
• Providers in Stevensville, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.