KRISTEN GRACE MCGRONAN
NPI 1255004107
Nurse Practitioner - Family in Salisbury, MD
NPI Status: Active since July 27, 2021
Contact Information
100 E CARROLL ST
SALISBURY, MD
ZIP 21801
Phone: (410) 543-7006
- Individual
- Female
- Years of Experience 3
- Nurse Practitioner
- Family
- PECOS Enrolled
- Accepts Medicare Approved Payment
About KRISTEN MCGRONAN
Kristen Mcgronan is a provider established in Salisbury, Maryland and her medical specialization is Nurse Practitioner with a focus in family with more than 3 years of experience. The healthcare provider is registered in the NPI registry with number 1255004107 assigned on July 2021. The practitioner's primary taxonomy code is 363LF0000X with license number AC004010 (MD). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1255004107
- Provider Name
- KRISTEN GRACE MCGRONAN
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 100 E CARROLL ST SALISBURY, MD 21801
- Location Phone
- (410) 543-7006
- Mailing Address
- 701 MIDDLEFORD RD SEAFORD, DE 19973
- Mailing Phone
- (302) 628-6344
- Medical School Name
- OTHER
- Graduation Year
- 2021
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 07-27-2021
- Last Update Date
- 01-25-2023
- Code Navigator
A nurse practitioner (NP) like Kristen Mcgronan is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Kristen Mcgronan is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
The typical physician office visit costs for Medicare beneficiaries in this area are: $23.33 for a new patient copayment and $26.89 for an established patient copayment.
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- AC004010
- License State
- MD
Location Map
Secondary Locations
- 701 Middleford Rd
Seaford, DE 19973
(302) 628-6344
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | APP-000023061 (DE) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Ambetter from Home State Health
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Clear Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
Ambetter from Nebraska Total Care
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Clear Silver + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
Ambetter from NH Healthy Families
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
Ambetter from Sunflower Health Plan
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Clear Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
Ambetter Health of Delaware
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Clear Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
Ambetter of Illinois
- Central Bronze - HMO
- Central Bronze + Vision + Adult Dental - HMO
- Central Gold - HMO
- Central Gold + Vision + Adult Dental - HMO
- Central Silver - HMO
- Central Silver + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Clear Silver + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
AmeriHealth Caritas Next
- AmeriHealth Caritas Next Bronze Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals - HMO
- AmeriHealth Caritas Next Expanded Bronze Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals - HMO
- AmeriHealth Caritas Next Expanded Bronze Premier + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals Plan - HMO
- AmeriHealth Caritas Next Gold Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals - HMO
- AmeriHealth Caritas Next Silver Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals - HMO
- AmeriHealth Caritas Next Silver Premier + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals Plan - HMO
Highmark Blue Cross Blue Shield Delaware
- my Blue Access Major Events PPO Catastrophic 9450 - 3 Free PCP Visits - PPO
- my Blue Access PPO Bronze 3800 - PPO
- my Blue Access PPO Bronze 3800 + Adult Dental and Vision - PPO
- my Blue Access PPO Bronze 7100 HSA - Custom Drug Benefit - PPO
- my Blue Access PPO Bronze 8900 - PPO
- my Blue Access PPO Gold 0 - PPO
- my Blue Access PPO Gold 0 + Adult Dental and Vision - PPO
- my Blue Access PPO Gold 1700 HSA - PPO
- my Blue Access PPO Platinum 0 - PPO
- my Blue Access PPO Platinum 0 + Adult Dental and Vision - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
PECOS Enrollment and Medicare Participation Status
Kristen Mcgronan is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 1557757598
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20220331000756
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 21801 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $93.34
- Minimum New Patient Price $60.77
- Maximum New Patient Price $183.88
- Average New Patient Copayment $23.33
- Minimum New Patient Copayment $15.19
- Maximum New Patient Copayment $45.97
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $107.57
- Minimum Established Patient Price $18.98
- Maximum Established Patient Price $150.13
- Average Established Patient Copayment $26.89
- Minimum Established Patient Copayment $4.74
- Maximum Established Patient Copayment $37.53
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Hospital Affiliations
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Kristen Mcgronan is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
PENINSULA REGIONAL MEDICAL CENTER | 100 EAST CARROLL AVENUE SALISBURY, MD 21801 | (410) 546-6400 | Acute Care Hospitals | |
TIDALHEALTH NANTICOKE, INC. | 801 MIDDLEFORD RD SEAFORD, DE 19973 | (302) 629-6611 | Acute Care Hospitals | |
BEEBE MEDICAL CENTER | 424 SAVANNAH RD LEWES, DE 19958 | (302) 645-3300 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 2 | 5 | 5 | 0 | 0 | 4 | 1 | 0 | 7 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 2 | 10 | 5 | 0 | 0 | 8 | 1 | 0 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 2 + 1 + 0 + 5 + 0 + 0 + 8 + 1 + 0 + 24 = 43 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
50 - 43 = 7 | 7 |
The NPI number 1255004107 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1023017134 | CHARLES B SILVIA JR. MD Individual | Internal Medicine | 100 E CARROLL ST INPATIENT SERVICES SALISBURY, MD 21801 (410) 543-7536 |
1902887425 | ASSOCIATED ANESTHESIOLOGY PRACTICE P.A. Organization | Anesthesiology | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7375 |
1194706622 | DR. JOHN J GIUSTOZZI M.D. Individual | Anesthesiology | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7375 |
1609858935 | DR. JOHN Y CHUN M.D. Individual | Anesthesiology | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7375 |
1205818549 | DR. BRENT R FOX M.D. Individual | Anesthesiology | 100 E CARROLL ST SALISBURY, MD 21801 (410) 742-4401 |
1740262096 | DR. JAMES MARK SKOLKA M.D. Individual | Anesthesiology | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7375 |
1568443836 | DR. THOMAS E KELLY M.D. Individual | Anesthesiology | 100 E CARROLL ST SALISBURY, MD 21801 (410) 742-4401 |
1568444552 | DR. PATRICK MCCULLOUGH DOM M.D. Individual | Anesthesiology | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7375 |
1720061575 | STEPHEN R MCKERROW CRNA Individual | Nurse Anesthetist, Certified Registered | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7375 |
1588648802 | WILLIAM J STANTON CRNA Individual | Nurse Anesthetist, Certified Registered | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7375 |
1801870373 | MARY DRISCOLL SCHAEFFER CRNA Individual | Nurse Anesthetist, Certified Registered | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7375 |
1053395905 | CHRISTOPHER M CLIFFORD CRNA Individual | Nurse Anesthetist, Certified Registered | 100 E CARROLL ST SALISBURY, MD 21801 (410) 742-4401 |
1902885825 | STEPHEN F SILTMAN CRNP Individual | Nurse Practitioner | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7100 |
1023097953 | WILLIAM C TODD MD Individual | Emergency Medicine | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7100 |
1356320360 | DONALD A MULLEN MD Individual | Emergency Medicine | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7100 |
1700865623 | CLARK H WILLIS MD Individual | Emergency Medicine | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7100 |
1871572776 | MICHAEL R CHAIKEL PAC Individual | Physician Assistant | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7100 |
1528038361 | PANPIT KLUG M.D. Individual | Internal Medicine (Hematology & Oncology) | 100 E CARROLL ST SALISBURY, MD 21801 (410) 749-1282 |
1235109760 | KEVIN A MCCABE PAC Individual | Emergency Medicine | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7100 |
1215900691 | ELIZABETH K KOVAL MD Individual | Emergency Medicine | 100 E CARROLL ST SALISBURY, MD 21801 (410) 543-7100 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255004107, enumerated in the NPI registry as an "individual" on July 27, 2021
The provider is located at 100 E Carroll St Salisbury, Md 21801 and the phone number is (410) 543-7006
The provider's speciality is Nurse Practitioner with taxonomy code 363LF0000X with a focus in Family
The provider has more than 3 years of experience.
The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of May 17, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $93.34 with an average copayment of $23.33 for new patient appointments. Established patients should expect a typical charge of $107.57 and an average copayment of 26.89. Please review your insurance plan or contact the provider directly to determine your specific costs.
The practitioner is affiliated to the following hospital(s): PENINSULA REGIONAL MEDICAL CENTER, TIDALHEALTH NANTICOKE, INC. and BEEBE MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on July 27, 2021. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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