Individual provider Active NPI

Roselen Villalba, CRNP

  • Family Nurse Practitioner
  • Allentown, PA
National Provider Identifier
1053196089
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP029685 Issued in PA
Practice address
1627 Chew St Ste 403
Allentown, PA 18102-3648
Phone
(610) 969-3500
Fax
(610) 969-3601
NPI assigned
Aug 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP029685 PA
Family Nurse Practitioner 363LF0000X SP029685 PA Primary
Registered Nurse 163W00000X RN610225 PA

Addresses

Primary practice location

1627 Chew St Ste 403
Allentown, PA 18102-3648

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (484) 884-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240516001953 PA Practitioner - Nurse Practitioner 1456792852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1627 Chew St
Allentown, PA 18102-3648

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN610225PAMDRegistered Nurse
SP029685PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Health Partners Community Health Center Current Accepting new patients

Locations

1627 Chew St
Fl 1
Allentown, PA 18102
Phone (610) 969-2800

1627 Chew St
Ste 403
Allentown, PA 18102
Phone (610) 696-4300

Interoperability endpoints

  • Direct secure messaging: rvillalba9749@direct2.lvhn.org

Organizations & group practices 2

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 5

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": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1053196089",
    "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": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 CHEW ST STE 403",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181023648",
            "telephone_number": "610-969-3500",
            "fax_number": "610-969-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALBA",
        "first_name": "ROSELEN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP029685",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP029685",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN610225",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.