NPIMap

Individual provider Active NPI

Eileen M Pack, CRNP

  • Nurse Practitioner
  • North East, MD
National Provider Identifier
1992078141
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R125856 Issued in MD
Practice address
322 E Cecil Ave # 1
North East, MD 21901-4012
Phone
(410) 287-5570
NPI assigned
Feb 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R125856 MD Primary
Nurse Practitioner 363L00000X AC001006 MD

Addresses

Primary practice location

322 E Cecil Ave # 1
North East, MD 21901-4012

Mailing address

322 E Cecil Ave # 1
North East, MD 21901-4012
Phone (410) 287-5570

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120329000475 MD Practitioner - Nurse Practitioner 8729248646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Union Hospital of Cecil CountyGroup PAC ID 6901719822, 281 clinicians

Practice addresses (Care Compare)

103 N E PLZ
Union Primary Care North East
North East, MD 21901-3633
Phone (410) 287-5570

106 Bow St
Elkton, MD 21921-5544
Phone (410) 398-4000

111 W High St
Union Primary Care of Elkton Suite 314
Elkton, MD 21921-8617
Phone (410) 620-0545

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Elkton, MD, CCN 217151
  • Bayada Home Health Care, Inc. Home health agency, Towson, MD, CCN 217101
  • Union Hospital of Cecil County Hospital, Elkton, MD, CCN 210032
  • Christiana Hospital Hospital, Newark, DE, CCN 080001

Merit-based Incentive Payment System (MIPS)

Final score
78.57 of 100Reported as group
Quality
59.34
Promoting interoperability
89
Improvement activities
40
Cost
75.04

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County CurrentSince Sep 21, 2020 Accepting new patients

Locations

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

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 7

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": "1329696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1992078141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 E CECIL AVE # 1",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219014012",
            "telephone_number": "410-287-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 E CECIL AVE # 1",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219014012",
            "telephone_number": "410-287-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "EILEEN",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-20",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R125856",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "AC001006",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North East, MD

Sources for this page

Verify at the official NPI Registry.