Individual provider Active NPI

Asta Elizabeth Puskarich, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Nottingham, MD
National Provider Identifier
1538997283
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R814811 Issued in MD
Practice address
5022 Campbell Blvd Ste L-M
Nottingham, MD 21236-4969
Phone
(443) 442-1568
Fax
(443) 442-1569
NPI assigned
Jul 24, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X R184811 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R814811 MD Primary

Addresses

Primary practice location

5022 Campbell Blvd Ste L-M
Nottingham, MD 21236-4969

Mailing address

5200 Campbell Blvd Ste L-M
Nottingham, MD 21236-4983
Phone (443) 442-1568

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
I20241023003949 MD Practitioner - Nurse Practitioner 3678006079

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aspire Wellness Center IncGroup PAC ID 2961685706, 41 clinicians

Practice addresses (Care Compare)

5022 Campbell Blvd
Suite L M
Nottingham, MD 21236-4969
Phone (443) 442-1568

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R184811MDMDAmbulatory Care Registered Nurse
R814811MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Wellness Center, Inc. CurrentSince Aug 11, 2024 Accepting new patients

Locations

5022 Campbell Blvd
Ste Lm
Nottingham, MD 21236
Phone (443) 442-1568

5022 Campbell Blvd
Ste L
Nottingham, MD 21236
Phone (443) 442-1568

Organizations & group practices 1

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": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1538997283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 CAMPBELL BLVD STE L-M",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364983",
            "telephone_number": "443-442-1568",
            "fax_number": "443-442-1569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5022 CAMPBELL BLVD STE L-M",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364969",
            "telephone_number": "443-442-1568",
            "fax_number": "443-442-1569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUSKARICH",
        "first_name": "ASTA",
        "middle_name": "ELIZABETH",
        "credential": "CRNP-PMH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "MD",
            "license": "R184811",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R814811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nottingham, MD

Sources for this page

Verify at the official NPI Registry.