Rebecca J. Mysiuk, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R202955 Issued in MD

Practice address

2339 Maytime Dr
Gambrills, MD 21054-1434

Phone

(410) 241-1806

NPI assigned

Feb 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24803/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/17833/brand/1/csg/1/fhir/r4

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.

• CTG LLC

  dba Caring House Calls

  • Medical Physician Assistant
  • Rockville, MD
  • NPI 1376914481

  DC

  Medicare reassignment NPD
• FNP Concierge Home Medical Services, LLC

  • Family Nurse Practitioner
  • Gambrills, MD
  • NPI 1265102545
  NPD Authorized official
• Onsite Medical Palliative Care LLC

  • Nurse Practitioner
  • Woodbine, MD
  • NPI 1124695143
  NPD (past)

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1730711748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2339 MAYTIME DR",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541434",
            "telephone_number": "410-241-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2339 MAYTIME DR",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541434",
            "telephone_number": "410-241-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYSIUK",
        "first_name": "REBECCA",
        "middle_name": "J.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R202955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F11190441",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebecca.mysiuk@nih.gov",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2339 Maytime Dr",
            "city": "Gambrills",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210541434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Darren Michael Moulden, PHARM.D.
• Tara Thurlby Muscovich, MD
• Nichole Lauren Muzii-Mills, AU.D.
• Deanne Lorraine Myers, R.N.
• Myeyedr Optometry of Maryland, LLC (MyEyeDr.)
• Nai Saturn Eastern LLC (Safeway Pharmacy #1596)
• Nai Saturn Eastern LLC (Safeway Pharmacy #1596)
• Mark Nalbandian, D.D.S
• Ardalan Nateghi, DDS
• National Rehabilitation Hospital, Inc (MedStar Health Physical Therapy at Waugh Chapel)

• Family Nurse Practitioner in Gambrills, MD
• Providers in Gambrills, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.