Individual provider Active NPI

Ella I Krupitskaya, CRNP

  • Gerontology Nurse Practitioner
  • Randallstown, MD
National Provider Identifier
1578863312
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R 173481 Issued in MD
Practice address
5400 Old Court Rd Ste 204
Randallstown, MD 21133-5126
Phone
(410) 521-4211
Fax
(410) 521-0627
NPI assigned
Oct 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R 173481 MD Primary

Addresses

Primary practice location

5400 Old Court Rd Ste 204
Randallstown, MD 21133-5126

Mailing address

5400 Old Court Rd Ste 204
Randallstown, MD 21133-5126
Phone (410) 521-4211

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110302000018 MD Practitioner - Nurse Practitioner 3274714803 Reassigns benefits to 2 organizations
I20111213000327 DC Practitioner - Nurse Practitioner 3274714803

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.29 of 100Reported as group
Quality
73.37
Improvement activities
40
Cost
83.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 173481MDMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care of Maryland LLC CurrentSince Apr 15, 2021 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Organizations & group practices 2

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": "1288137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1578863312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 OLD COURT RD STE 204",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335126",
            "telephone_number": "410-521-4211",
            "fax_number": "410-521-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 OLD COURT RD STE 204",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335126",
            "telephone_number": "410-521-4211",
            "fax_number": "410-521-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUPITSKAYA",
        "first_name": "ELLA",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-27",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R 173481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

Verify at the official NPI Registry.