Brenda L Vitucci, CRNP
Individual provider Active NPI Family Nurse Practitioner · Cascade, MD
NPI 1851494488 · NPPES record last updated Aug 30, 2023
Key facts
- NPI
- 1851494488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R081680 (MD)
- Practice address
- 14303 Lake Royer Dr
Cascade, MD 21719-1602 - Phone
- (240) 852-0694
- NPI assigned
- Sep 7, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 17
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Meritus Medical Center Inc
Medical Practices of Antietam, LLC
Practice addresses (Care Compare)
11110 Medical Campus Rd
Hagerstown, MD 21742-6700
3 Byrkit Dr
Williamsport, MD 21795-1158
Phone (301) 582-1150
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230703000547 | MD | Practitioner - Nurse Practitioner | 2961491360 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP015218 | PA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Practices of Antietam, LLC | Current |
Accepting new patients | |
| Medical Practices of Antietam LLC | Current |
Accepting new patients | |
| Johns Hopkins Community Physicians, Inc | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Johns Hopkins Community Physicians, Inc | Past | Accepting new patients | |
| Johns Hopkins Community Physicians | Past | Accepting new patients | |
| Meritus Medical Laboratory LLC | Past | Accepting new patients |
Locations
14303 Lake Royer Dr
Cascade, MD 21719
Phone (240) 582-0694
11110 Medical Campus Rd
Ste 130
Hagerstown, MD 21742
Phone (301) 665-4710
13620 Crayton Blvd
Hagerstown, MD 21742
Phone (240) 313-3100
11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600
22911 Jefferson Blvd
Smithsburg, MD 21783
Phone (301) 824-1711
3 Byrkit Dr
Williamsport, MD 21795
Phone (301) 582-1150
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R081680 | MD | Yes |
| Family Nurse Practitioner | 363LF0000X | SP015218 | PA |
Addresses
Primary practice location
14303 Lake Royer Dr
Cascade, MD 21719-1602
Mailing address
14303 Lake Royer Dr
Cascade, MD 21719-1602
Other practice location 1
1425 Philadelphia Ave
Chambersburg, PA 17201-1386
Phone (717) 217-6055
Other practice location 2
2075 Scotland Ave
Chambersburg, PA 17201-1451
Phone (717) 217-6055
Other practice location 3
2055 Scotland Ave
Chambersburg, PA 17201-1451
Phone (717) 217-6055
Other practice location 4
601 E Main St Level 3
Waynesboro, PA 17268-2332
Phone (717) 765-5087
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103040951 | Medicaid | PA |
Other providers in Cascade, MD
All providers in Cascade, MD · Family Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.