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CONSUELA J CRUDEN-PARHAM M.D.
NPI 1972784023
Obstetrics & Gynecology in Martinsburg, WV

Active since November 16, 2007PECOS EnrolledAccepts Medicare Assignment
99 TAVERN RD, MARTINSBURG, WV 25401(304) 263-8964 Get Directions Write a Review

NPPES record last updated: April 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 21, 2022, Jan 8, 2021 (2 updates tracked since 2021).

About Consuela J Cruden-parham M.d. NPPES

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

CONSUELA J CRUDEN-PARHAM M.D. (NPI 1972784023) is an individual obstetrics & gynecology provider in Martinsburg, West Virginia, licensed in West Virginia (22939) and active in the NPI registry since November 2007. She is enrolled in Medicare PECOS, is affiliated with Berkeley Medical Center, and is a graduate of Baylor College Of Medicine (2003).

NPPES Registry Identity

NPI1972784023
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameCONSUELA J CRUDEN-PARHAMCredential: M.D.
Location Address99 TAVERN RDMartinsburg, WV 25401-2890
Mailing AddressPo Box 1146Martinsburg, WV 25402-1146 · (304) 263-8964
Phone(304) 263-8964
Sole ProprietorNo
Medical School CMSBaylor College Of MedicineGraduated 2003
Enumeration DateNovember 16, 2007
Last NPPES UpdateApril 21, 20222 updates tracked since enumeration
NPPES CertifiedApril 21, 2022
✔ NPI 1972784023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in WV · 22939
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
99 TAVERN RD, Martinsburg, WV 25401
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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 and accepts Medicare assignment

Consuela J Cruden-parham M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4688703838
PECOS Enrollment IDI20100526000326
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 Reassignments

4

Medicare enrollment records show Consuela Cruden-parham reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

City Hospital, Inc.
0.8 mi
Internal Medicine
2500 HOSPITAL DR
Martinsburg, WV 25401
  • Reassigned Medicare billing, West Virginia enrollment
  • 231 clinicians in this Medicare group
NPI 1194141499 (304) 264-1249
University Healthcare Physicians Inc
0.8 mi
Anesthesiology
2500 FOUNDATION WAY
Martinsburg, WV 25401
  • Reassigned Medicare billing, West Virginia enrollment
  • 208 clinicians in this Medicare group
NPI 1417371329 (304) 264-9202
University Hematology And Oncology
0.8 mi
Clinical Medical Laboratory
2008 PROFESSIONAL CT
Martinsburg, WV 25401
  • Reassigned Medicare billing, West Virginia enrollment
  • Medicare enrollment name: West Virginia University Medical Corporation
  • 2,471 clinicians in this Medicare group
NPI 1306125612 (304) 293-7401
Jefferson Memorial Hospital
13 mi
Critical Access
300 S. PRESTON STREET
Ranson, WV 25438
  • Reassigned Medicare billing, West Virginia enrollment
  • 110 clinicians in this Medicare group
NPI 1891722377 (304) 728-1600

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
39 services26 patients

Hospital Affiliations CMS Care Compare 2

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

Berkeley Medical Center

Acute Care Hospitals · Martinsburg, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510008
Location2500 Hospital DriveMartinsburg, WV 25401 · Berkeley County
Emergency services Birthing friendly

Jefferson Medical Center

Critical Access Hospitals · Ranson, WV
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number511319
Location300 South Preston StreetRanson, WV 25438 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25401 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
$124.46 typical visit price
range $53.20 – $164.59
Typical copayment $31.11 (range $13.30 – $41.14)
Most-billed visit code 99204
Established Patient
$66.84 typical visit price
range $16.47 – $133.29
Typical copayment $16.71 (range $4.11 – $33.32)
Most-billed visit code 99213
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 20

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

CASSIE ANN MCNAMEE
Nurse Practitioner (Family)
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (304) 263-4999
SHENANDOAH VALLEY MEDICAL SYSTEM, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (304) 263-4999
GIANLUCA LAMONACA M.D.
Psychiatry & Neurology (Child & Adolescent Psychiatry)
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (304) 263-7023
PRISCILLA BRYANT-SCHOENLY MSW
Social Worker (Clinical)
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (302) 263-4999
KAREN ELIZABETH LAAKANIEMI MSN,CNM
Midwife
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (304) 264-0660
KRISTA HOPKINS M.D.
Obstetrics & Gynecology
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (304) 263-4999
MRS. MICHELE M SHEETZ FNP
Nurse Practitioner (Family)
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (304) 263-4999
LINDA GILLET CNM
Midwife
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (304) 263-4999

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 Consuela Cruden-parham's NPI number?

The NPI number for Consuela Cruden-parham is 1972784023. It was assigned to this individual provider in the NPPES registry on November 16, 2007.

Where is Consuela Cruden-parham located?

Consuela Cruden-parham practices at 99 Tavern Rd, Martinsburg, WV 25401. The listed phone number is (304) 263-8964.

What is Consuela Cruden-parham's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Consuela Cruden-parham enrolled in Medicare?

Yes. Consuela Cruden-parham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Consuela Cruden-parham's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Consuela Cruden-parham reassigns Medicare benefits to 4 organizations: City Hospital, Inc. (Martinsburg, WV), University Healthcare Physicians Inc (Martinsburg, WV), University Hematology And Oncology (Martinsburg, WV) and Jefferson Memorial Hospital (Ranson, WV). Each 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 Consuela Cruden-parham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Consuela Cruden-parham accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and Molina Healthcare list Consuela Cruden-parham 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 Consuela Cruden-parham affiliated with any hospitals?

According to CMS data, Consuela Cruden-parham is affiliated with Berkeley Medical Center and Jefferson Medical Center.

When was this NPI record last updated?

The NPPES record for Consuela Cruden-parham was last updated on April 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.