Individual provider Active NPI

Marianna Evelyn Pretulak, ACNP-BC

  • Acute Care Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1942520002
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4155 Issued in SC
Practice address
1005 Grove Rd
Greenville, SC 29605-4630
Phone
(864) 455-6900
Fax
(864) 255-5619
NPI assigned
Jun 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4155 SC Primary

Addresses

Primary practice location

1005 Grove Rd
Greenville, SC 29605-4630

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8614

Other identifiers 1

IdentifierTypeStateIssuer
NP1677MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpretulak6047@direct.ghs.myhfn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20110121001014 SC Practitioner - Nurse Practitioner 3274712245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Carolina School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

701 Grove Rd
Greenville, SC 29605-4210

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 3, 2012 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients

Locations

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

9 Richland Medical Park Dr
Ste 450
Columbia, SC 29203
Phone (803) 434-8800

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

175 Patewood Dr
Greenville, SC 29615
Phone (864) 797-1000

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

1005 Grove Rd
Greenville, SC 29605
Phone (864) 235-7665

712 Grove Rd
Greenville, SC 29605
Phone (864) 271-1444

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

701 Grove Rd
Fl 5
Greenville, SC 29605
Phone (864) 455-4411

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

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": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1942520002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054630",
            "telephone_number": "864-455-6900",
            "fax_number": "864-255-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRETULAK",
        "first_name": "MARIANNA",
        "middle_name": "EVELYN",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-10",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "4155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1677",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpretulak6047@direct.ghs.myhfn.org",
            "affiliation": "N",
            "address_1": "1005 Grove Rd",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296054630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.