Individual provider Active NPI

Catherine James Mauriello, CRNP

  • Adult Health Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1811330277
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R186270 Issued in MD
Practice address
5457 Twin Knolls Rd Ste 100
Columbia, MD 21045-3263
Phone
(410) 689-7400
NPI assigned
Apr 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R186270 MD Primary

Addresses

Primary practice location

5457 Twin Knolls Rd Ste 100
Columbia, MD 21045-3263

Mailing address

17855 Dallas Pkwy Ste 200
Dallas, TX 75287-6857
Phone (346) 376-1702

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
I20131008001330 MD Practitioner - Nurse Practitioner 8123252004 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Agnes Healthcare IncGroup PAC ID 9830092733, 265 clinicians

Practice addresses (Care Compare)

900 Caton Ave
Baltimore, MD 21229-5201
Phone (667) 234-3120

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R186270MDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Agnes Healthcare Inc CurrentSince Nov 21, 2022 Accepting new patients
Onsite Medical Palliative Care LLC CurrentSince Oct 6, 2021 Accepting new patients
St Agnes Healthcare Inc CurrentSince Nov 21, 2022 Accepting new patients
Seasons Medical Group of Maryland PC CurrentSince Jun 20, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

5457 Twin Knolls Rd
Ste 100
Columbia, MD 21045
Phone (410) 689-7400

17855 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 201-3800

Interoperability endpoints

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

Organizations & group practices 5

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": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1811330277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17855 DALLAS PKWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752876857",
            "telephone_number": "346-376-1702",
            "fax_number": "224-532-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5457 TWIN KNOLLS RD STE 100",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453263",
            "telephone_number": "410-689-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURIELLO",
        "first_name": "CATHERINE",
        "middle_name": "JAMES",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R186270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.