Individual provider Active NPI

Susan D Ellis, CRNA

  • Certified Registered Nurse Anesthetist
  • Camp Hill, PA
National Provider Identifier
1669409462
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
47776AANA Issued in PA
Practice address
503 N 21St Street
Camp Hill, PA 17011
Phone
(717) 763-2121
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 47776AANA PA Primary

Addresses

Primary practice location

503 N 21St Street
Camp Hill, PA 17011

Mailing address

1460 Hambiltonian Way
York, PA 17404
Phone (717) 767-6031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091001000701 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214073477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penn State Health Medical Group LLCGroup PAC ID 8729351077, 720 clinicians

Practice addresses (Care Compare)

1120 Cocoa Ave
Hershey, PA 17033-1712
Phone (717) 533-4141

503 N 21St St
Camp Hill, PA 17011-2204
Phone (717) 763-2100

Hospital & facility affiliations

  • Penn State Health Holy Spirit Medical Center Hospital, Camp Hill, PA, CCN 390004

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
47776AANAPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC Current Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2022 Accepting new patients

Locations

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

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.

Hospital & facility affiliations 2

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669409462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 HAMBILTONIAN WAY",
            "city": "YORK",
            "state": "PA",
            "postal_code": "17404",
            "telephone_number": "717-767-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 N 21ST STREET",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "17011",
            "telephone_number": "717-763-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "SUSAN",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "47776AANA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.