ELLEN R SUPERDOCK CRNP
NPI 1497306336
Nurse Practitioner - Family in Lebanon, PA

Active since September 23, 2019PECOS Enrolled
920 CHURCH ST, LEBANON, PA 17046(717) 272-2700 Get Directions Write a Review

NPPES record last updated: March 4, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 4, 2021, Sep 23, 2019 (2 updates tracked since 2019).

About Ellen R Superdock Crnp NPPES

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

ELLEN R SUPERDOCK CRNP (NPI 1497306336) is an individual family provider in Lebanon, Pennsylvania, licensed in Pennsylvania (SP020508) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in New Holland.

NPPES Registry Identity

NPI1497306336
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameELLEN R SUPERDOCKCredential: CRNP
Location Address920 CHURCH STLebanon, PA 17046-4656
Mailing Address304 N Water StLancaster, PA 17603-3374 · (717) 735-6808 · Fax (717) 325-8057
Sole ProprietorNo
Enumeration DateSeptember 23, 2019
Last NPPES UpdateMarch 4, 20212 updates tracked since enumeration
NPPES CertifiedMarch 4, 2021
NPI 1497306336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in PA · SP020508
920 CHURCH ST, Lebanon, PA 17046

Secondary Practice Location 1

Location 1435 S Kinzer Ave Ste 6New Holland, PA 17557-8706 · Phone (717) 351-2400

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

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

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17046 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

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

Nurse Practitioner (Family)
920 CHURCH ST
LEBANON, PA 17046
Nurse Practitioner (Family)
920 CHURCH ST
LEBANON, PA 17046
Community Health Worker
920 CHURCH ST
LEBANON, PA 17046
Nurse Practitioner (Family)
920 CHURCH ST
LEBANON, PA 17046
Pharmacy (Community/Retail Pharmacy)
920 CHURCH ST
LEBANON, PA 17046
Family Medicine
920 CHURCH ST
LEBANON, PA 17046
Dietitian, Registered
920 CHURCH ST
LEBANON, PA 17046
Clinic/Center (Federally Qualified Health Center (FQHC))
920 CHURCH ST
LEBANON, PA 17046

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 Superdock's NPI number?

The NPI number for Ellen Superdock is 1497306336. It was assigned to this individual provider in the NPPES registry on September 23, 2019.

Where is Ellen Superdock located?

Ellen Superdock practices at 920 Church St, Lebanon, PA 17046. The listed phone number is (717) 272-2700.

What is Ellen Superdock's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Ellen Superdock enrolled in Medicare?

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

What insurance does Ellen Superdock accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Ellen Superdock 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.

When was this NPI record last updated?

The NPPES record for Ellen Superdock was last updated on March 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.