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ELLEN PETRYNA
NPI 1396208807
Student in an Organized Health Care Education/Training Program in Charlotte, NC

Active since April 11, 2019PECOS Enrolled
1000 BLYTHE BLVD, CHARLOTTE, NC 28203(704) 355-2000 Get Directions Write a Review

NPPES record last updated: June 12, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 12, 2023, Apr 11, 2019 (2 updates tracked since 2019).

About Ellen Petryna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELLEN PETRYNA (NPI 1396208807) is an individual student in an organized health care education/training program in Charlotte, North Carolina and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, is affiliated with Carolinas Medical Center/behav Health, and maintains a secondary practice location in Memphis.

NPPES Registry Identity

NPI1396208807
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameELLEN PETRYNA
Location Address1000 BLYTHE BLVDCharlotte, NC 28203-5812
Mailing Address1000 Blythe BlvdCharlotte, NC 28203-5812 · (704) 355-2000
Phone(704) 355-2000
Sole ProprietorNo
Medical School CMSJc Edwards School Of Medicine, Marshall UniversityGraduated 2019
Enumeration DateApril 11, 2019
Last NPPES UpdateJune 12, 20232 updates tracked since enumeration
NPPES CertifiedJune 12, 2023
✔ NPI 1396208807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1000 BLYTHE BLVD, Charlotte, NC 28203
Open in Google Maps ↗

Secondary Practice Location 1

Location 1920 Madison Ave Ste 447Memphis, TN 38103-3438 · Phone (901) 448-5814

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ellen Petryna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID648503391
PECOS Enrollment IDI20260902003206
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ellen Petryna reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Atrium Health Specialty Network Inc
8.0 mi
Dermatology
10650 PARK RD
Charlotte, NC 28210
  • Reassigned Medicare billing, North Carolina enrollment
  • 300 clinicians in this Medicare group
NPI 1538975636 (704) 667-0340

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Carolinas Medical Center/Behav Health

Acute Care Hospitals · Charlotte, NC
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340113
Location1000 Blythe BlvdCharlotte, NC 28203 · Mecklenburg County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER EGAN M.D.
Pathology (Clinical Pathology/Laboratory Medicine)
1000 BLYTHE BLVD
CHARLOTTE, NC 28203
Mecklenburg County (704) 973-5500
CHELSEA KOLSHAK
Emergency Medicine
1000 BLYTHE BLVD
CHARLOTTE, NC 28203
Mecklenburg County (704) 355-3658
NEHA RAY MD
Emergency Medicine
1000 BLYTHE BLVD
CHARLOTTE, NC 28203
Mecklenburg County (704) 355-3181
DR. HANNAH ELIZABETH CORRAL MD
Emergency Medicine
1000 BLYTHE BLVD
CHARLOTTE, NC 28203
Mecklenburg County (704) 355-3658
PRECIOUS IRIAGHOMO WOODWARD
Nurse Anesthetist, Certified Registered
1000 BLYTHE BLVD
CHARLOTTE, NC 28203
Mecklenburg County (704) 355-2000
ALEXANDRU DANIEL VLASIN CRNA
Nurse Anesthetist, Certified Registered
1000 BLYTHE BLVD
CHARLOTTE, NC 28203
Mecklenburg County (704) 355-2000
BROOKE STEPHANIK
Pharmacist (Pediatrics)
1000 BLYTHE BLVD
CHARLOTTE, NC 28203
Mecklenburg County (704) 381-2000
DR. BERNARD VELARDO MD
Anesthesiology
1000 BLYTHE BLVD
CHARLOTTE, NC 28203
Mecklenburg County (704) 355-2000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ellen Petryna's NPI number?

The NPI number for Ellen Petryna is 1396208807. It was assigned to this individual provider in the NPPES registry on April 11, 2019.

Where is Ellen Petryna located?

Ellen Petryna practices at 1000 Blythe Blvd, Charlotte, NC 28203. The listed phone number is (704) 355-2000.

What is Ellen Petryna's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ellen Petryna enrolled in Medicare?

Yes. Ellen Petryna is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ellen Petryna's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ellen Petryna reassigns Medicare benefits to Atrium Health Specialty Network Inc (Charlotte, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ellen Petryna's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ellen Petryna accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC list Ellen Petryna as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Ellen Petryna affiliated with any hospitals?

According to CMS data, Ellen Petryna is affiliated with Carolinas Medical Center/Behav Health.

When was this NPI record last updated?

The NPPES record for Ellen Petryna was last updated on June 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.