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

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  • 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
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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

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)
1363LF0000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner
Family

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 CENTER100 EAST CARROLL AVENUE
SALISBURY, MD 21801
(410) 546-6400Acute Care Hospitals
TIDALHEALTH NANTICOKE, INC.801 MIDDLEFORD RD
SEAFORD, DE 19973
(302) 629-6611Acute Care Hospitals
BEEBE MEDICAL CENTER424 SAVANNAH RD
LEWES, DE 19958
(302) 645-3300Acute 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.
1255004107
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2210500810
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 = 77

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 Medicine100 E CARROLL ST INPATIENT SERVICES
SALISBURY, MD 21801
(410) 543-7536
1902887425ASSOCIATED ANESTHESIOLOGY PRACTICE P.A.
Organization
Anesthesiology100 E CARROLL ST
SALISBURY, MD 21801
(410) 543-7375
1194706622DR. JOHN J GIUSTOZZI M.D.
Individual
Anesthesiology100 E CARROLL ST
SALISBURY, MD 21801
(410) 543-7375
1609858935DR. JOHN Y CHUN M.D.
Individual
Anesthesiology100 E CARROLL ST
SALISBURY, MD 21801
(410) 543-7375
1205818549DR. BRENT R FOX M.D.
Individual
Anesthesiology100 E CARROLL ST
SALISBURY, MD 21801
(410) 742-4401
1740262096DR. JAMES MARK SKOLKA M.D.
Individual
Anesthesiology100 E CARROLL ST
SALISBURY, MD 21801
(410) 543-7375
1568443836DR. THOMAS E KELLY M.D.
Individual
Anesthesiology100 E CARROLL ST
SALISBURY, MD 21801
(410) 742-4401
1568444552DR. PATRICK MCCULLOUGH DOM M.D.
Individual
Anesthesiology100 E CARROLL ST
SALISBURY, MD 21801
(410) 543-7375
1720061575 STEPHEN R MCKERROW CRNA
Individual
Nurse Anesthetist, Certified Registered100 E CARROLL ST
SALISBURY, MD 21801
(410) 543-7375
1588648802 WILLIAM J STANTON CRNA
Individual
Nurse Anesthetist, Certified Registered100 E CARROLL ST
SALISBURY, MD 21801
(410) 543-7375
1801870373 MARY DRISCOLL SCHAEFFER CRNA
Individual
Nurse Anesthetist, Certified Registered100 E CARROLL ST
SALISBURY, MD 21801
(410) 543-7375
1053395905 CHRISTOPHER M CLIFFORD CRNA
Individual
Nurse Anesthetist, Certified Registered100 E CARROLL ST
SALISBURY, MD 21801
(410) 742-4401
1902885825 STEPHEN F SILTMAN CRNP
Individual
Nurse Practitioner100 E CARROLL ST
SALISBURY, MD 21801
(410) 543-7100
1023097953 WILLIAM C TODD MD
Individual
Emergency Medicine100 E CARROLL ST
SALISBURY, MD 21801
(410) 543-7100
1356320360 DONALD A MULLEN MD
Individual
Emergency Medicine100 E CARROLL ST
SALISBURY, MD 21801
(410) 543-7100
1700865623 CLARK H WILLIS MD
Individual
Emergency Medicine100 E CARROLL ST
SALISBURY, MD 21801
(410) 543-7100
1871572776 MICHAEL R CHAIKEL PAC
Individual
Physician Assistant100 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 Medicine100 E CARROLL ST
SALISBURY, MD 21801
(410) 543-7100
1215900691 ELIZABETH K KOVAL MD
Individual
Emergency Medicine100 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.