NPIMap

Individual provider Active NPI

Jicenda B Contreras, CRNP

  • Family Nurse Practitioner
  • Macungie, PA
National Provider Identifier
1043967714
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP024706 Issued in PA
Practice address
6451 Village LN
Macungie, PA 18062-8484
Phone
(610) 967-2772
Fax
(610) 674-2528
NPI assigned
Mar 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP024706 PA Primary

Addresses

Primary practice location

6451 Village LN
Macungie, PA 18062-8484

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (484) 330-1377

Other identifiers 1

IdentifierTypeStateIssuer
SP024706OtherPASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220310002430 PA Practitioner - Nurse Practitioner 8820483712 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

6451 Village LN
Macungie, PA 18062-8484
Phone (610) 967-2772

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Centers Inc. Current Accepting new patients
Schuylkill Health System Medical Group, Inc. Family CurrentSince Oct 1, 2022 Accepting new patients
Schuylkill Health System Medical Group, Inc. CurrentSince Oct 1, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Mar 21, 2022 Accepting new patients
Family Care Centers Inc CurrentSince Sep 11, 2023 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Mar 21, 2022 Accepting new patients

Locations

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

2100 Mack Blvd
Fl 4
Allentown, PA 18103

120 Burrus Blvd
Brodheadsville, PA 18322
Phone (570) 402-6101

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

200 E Brown St
East Stroudsburg, PA 18301
Phone (570) 476-3700

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

6451 Village Ln
Macungie, PA 18062
Phone (610) 967-2772

200 Schuylkill Medical Plz
Pottsville, PA 17901
Phone (570) 621-9200

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

Interoperability endpoints

  • Direct secure messaging: jcontreras10819@direct2.lvhn.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1043967714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-330-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 VILLAGE LN",
            "city": "MACUNGIE",
            "state": "PA",
            "postal_code": "180628484",
            "telephone_number": "610-967-2772",
            "fax_number": "610-674-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONTRERAS",
        "first_name": "JICENDA",
        "middle_name": "B",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP024706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "SP024706",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macungie, PA

Sources for this page

Verify at the official NPI Registry.