Individual provider Active NPI

Jenna Nicole Breth

  • Physician Assistant
  • Newark, DE
National Provider Identifier
1104661388
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4755 Ogletown Stanton Rd
Newark, DE 19718-0002
Phone
(302) 733-1000
NPI assigned
Jun 28, 2024
Last updated
Jun 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd
Newark, DE 19718-0002

Mailing address

523 N Broad St Apt 504
Philadelphia, PA 19123-4149
Phone (814) 516-0763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20251209000004 DE Practitioner - Physician Assistant 9133613177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

621 Middletown Odessa Rd
Middletown, DE 19709-9602
Phone (302) 203-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Emergency Physicians LLC Physician Assistant CurrentSince Sep 27, 2025 Accepting new patients

Locations

621 Middletown Odessa Rd
Middletown, DE 19709
Phone (302) 203-1300

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1104661388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 N BROAD ST APT 504",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191234149",
            "telephone_number": "814-516-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197180002",
            "telephone_number": "302-733-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRETH",
        "first_name": "JENNA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.