NPIMap

Individual provider Active NPI

Lucille M Broelmann, CRNA

  • Certified Registered Nurse Anesthetist
  • Baltimore, MD
National Provider Identifier
1992769566
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AC000127 Issued in MD
Practice address
9000 Franklin Square Dr
2 North
Baltimore, MD 21237-3901
Phone
(443) 777-7179
Fax
(443) 777-8242
NPI assigned
Apr 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AC000127 MD Primary

Addresses

Primary practice location

9000 Franklin Square Dr
2 North
Baltimore, MD 21237-3901

Mailing address

9000 Franklin Square Dr
2 North
Baltimore, MD 21237-3901
Phone (443) 777-7179

Other identifiers 1

IdentifierTypeStateIssuer
AC000127OtherMDCRNA

Other names 1

  • Lucille M Recupero Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Mid-Atlantic Anesthesia Associates PC Nurse Anesthetist, Certified Registered PastSince Mar 7, 2011 Accepting new patients
Central Virginia Anesthesia Associates, LLC Past Accepting new patients
Society Hill Anesthesia Consultants, PC Past Accepting new patients
Chesapeake Pain Management, LLC Past Accepting new patients
Seaford Endoscopy Center LLC Past Accepting new patients
Medstar Health Anesthesia Services D, LLC Past Accepting new patients
North American Partners in Anesthesia Delaware LLC Past Accepting new patients
Delaware Coastal Anesthesia LLC Past Accepting new patients
Atlantic Medical Specialists, LLC PastSince Oct 1, 2012 Accepting new patients
Chesapekae Perioperative Services L.L.C. Past Accepting new patients

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992769566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 FRANKLIN SQUARE DR",
            "address_2": "2 NORTH",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373901",
            "telephone_number": "443-777-7179",
            "fax_number": "443-777-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 FRANKLIN SQUARE DR",
            "address_2": "2 NORTH",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373901",
            "telephone_number": "443-777-7179",
            "fax_number": "443-777-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROELMANN",
        "first_name": "LUCILLE",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "AC000127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA",
            "identifier": "AC000127",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCILLE",
            "last_name": "RECUPERO",
            "middle_name": "M",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.