Individual provider Active NPI

Eliana Marcela Serna Martinez

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1124764840
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP023867 Issued in PA
Practice address
5675 N Front St
Philadelphia, PA 19120-2719
Phone
(215) 279-6999
NPI assigned
May 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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 SP023867 PA Primary

Addresses

Primary practice location

5675 N Front St
Philadelphia, PA 19120-2719

Mailing address

5675 N Front St Ste 141
Philadelphia, PA 19120-2719
Phone (267) 428-6575

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
I20220823003720 PA Practitioner - Nurse Practitioner 2062895089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Jefferson Medical College of Thomas Jefferson University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dedicated Pennsylvania Holding LLC 19 clinicians

Practice addresses (Care Compare)

5675 N Front St
141 Dedicated Pennsylvania Olney
Philadelphia, PA 19120-2719
Phone (305) 628-6117

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Pennsylvania Holding, LLC Current Accepting new patients
Dedicated Pennsylvania Holding, LLC CurrentSince May 1, 2025 Accepting new patients
Dedicated Pennsylvania Holding, LLC CurrentSince May 1, 2025 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

5675 N Front St
Ste 141
Philadelphia, PA 19120
Phone (267) 338-3411

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1124764840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5675 N FRONT ST STE 141",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202719",
            "telephone_number": "267-428-6575",
            "fax_number": "267-262-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5675 N FRONT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202719",
            "telephone_number": "215-279-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERNA MARTINEZ",
        "first_name": "ELIANA",
        "middle_name": "MARCELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-05",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP023867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.